Torsion utérine au cours d’une grossesse gémellaire

Thubert, Thibault; Razak, R Abdul; Villefranque, Vincent; Muray, Jean; Picone, Olivier; Deffieux, X.

doi:10.1016/j.jgyn.2010.12.005

Cited by 7 publications

(6 citation statements)

References 9 publications

(19 reference statements)

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“…If reduction is not possible, it is essential to perform the hysterotomy away from the lateral edges of the uterus to preserve the vascular pedicles and ureters. The choice of a vertical hysterotomy is then preferable [3]. The risk of postpartum hemorrhage as in our case may be increased by acute ischemia of the myometrium responsible for atony which may lead to hemostatic hysterectomy [3].…”

Section: Discussionmentioning

confidence: 84%

“…Most commonly, torsion occurs during labour. Symptomatology included metrorrhagia, cervical dystocia, uterine pain, hyperkinesia, hypertonia, and even hemorrhagic shock [3]. et al found that the symptomatology is proportional to the importance of the torsion [2].…”

Section: Discussionmentioning

confidence: 99%

“…Intraoperative findings frequently include ascites and numerous varices around the isthmic portion [3]. When the torsion exceeds 180 degrees, the diagnosis is difficult to make and the hysterotomy may be inadvertently performed on the posterior aspect of the uterus.…”

Section: Discussionmentioning

confidence: 99%

“…If the situation is recognized prior to hysterotomy, a reduction of the uterine torsion can be attempted in order to incise in classic territory as we have attempted. This most often involves uterine exteriorization [3]. If reduction is not possible, it is essential to perform the hysterotomy away from the lateral edges of the uterus to preserve the vascular pedicles and ureters.…”

Section: Discussionmentioning

confidence: 99%

“…The cases described in the published literature generally present up to 180 degrees of torsion, but some go up to 720 degrees [2]. This anomaly has only been observed in three cases of twin pregnancies [3]. Clinical symptoms range from asymptomatic to extreme abdominal pain.…”

Section: Introductionmentioning

confidence: 99%

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Acute Gravid Uterine Torsion: Case Report about an Uncommon Obstetric Emergency

Slaoui¹

2022

J Androl Gynaecol

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Introduction: Uterine torsion is defined by a vertical rotation of more than 45 degrees around its cervical-isthmic axis. It is a rare emergency with serious complications that can be life-threatening for the fetus and the mother. Its pathophysiology has not yet been fully explained but this situation is generally the result of a several factors with mainly the asymmetry of the transverse diameter of the uterus and pelvic adhesions. Case Presentation:We hereby report the case of a 26-year-old female patient, third gesture fourth pare without particular medical history, who presented to the emergency department at 37 weeks of amenorrhea of a twin pregnancy with severe abdominal pain of sudden onset. Initially mistaken for retroplacental hemorrhage or uterine rupture, it was only in the pre operatory phase of an emergency cesarean section that the diagnosis of uterine torsion was made. The operation was complicated by postpartum hemorrhage due to uterine atony which was managed by prompt medical care and a triple Tsirulnikov ligation. She was discharged home with her two healthy newborns at D4 post-op. Conclusion:Uterine torsion is an uncommon and serious obstetric complication of difficult diagnosis that can be life-threatening for the fetus and the mother. The specificity of our case is twofold. Firstly, it is the third case of uterine torsion in twin pregnancy reported in the literature to date. Secondly, it is the first time to our knowledge that the difference in length of the two round ligaments is observed as a possible factor in the pathophysiology of this complication.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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