Uterine torsion: A review with critical considerations for the obstetrician and gynecologist

Liang, Raymond; Gandhi, Jason; Rahmani, Benjamin; Khan, Sardar

doi:10.1016/j.tria.2020.100084

Cited by 16 publications

(29 citation statements)

References 45 publications

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“…The paucity in reports of uterine torsion in premenopausal non-gravid women is likely to be due to the rarity of this pathology, which in turn can lead to a limited awareness and delay in diagnosis. These factors contribute to poorer outcomes for women, with high rates of morbidity and mortality [12,15].…”

Section: Discussionmentioning

confidence: 99%

The twisted uterus: A rare presentation of uterine torsion

Stannard¹,

Whittaker²,

Aziz³

et al. 2022

J Case Rep Images Obstet Gynecol

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Introduction: Uterine torsion is a rare gynecological emergency, defined as torsion of the uterus greater than 45° around its axis. Case reports describe torsion either in the gravid uterus or in postmenopausal women, yet rarely in the non-gravid, premenopausal uterus. This report describes the case of uterine torsion secondary to a large pedunculated fibroid in a 34-year-old nulliparous woman. Case Report:The patient presented with sudden onset of severe left sided abdominal pain which started during mild exertion. On examination she had a tender uterus which was enlarged secondary to a known large pedunculated fibroid. A planned myomectomy had been delayed due to the COVID-19 pandemic. Her pain worsened and therefore she was admitted with a working diagnosis of either torsion of the pedunculated fibroid or fibroid degeneration. A magnetic resonance imaging

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Section: Discussionmentioning

confidence: 99%

The twisted uterus: A rare presentation of uterine torsion

Stannard¹,

Whittaker²,

Aziz³

et al. 2022

J Case Rep Images Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…Parity has been associated with a higher risk of uterine torsion in animal models [ 8 ]. Case reports further describe uterine tenderness as a common feature of symptomatic gravid uterine torsion, whereas one case report specificaly describes the onset of isolated foetal tachycardia in an at term, again multiparous patient [ 1 , 2 ]. In this case, uterine activity and CTG alterations were observed 1 day after the last repositioning of the patient in left lateral tilt.…”

Section: Discussionmentioning

confidence: 99%

“…Uterine torsion is a rare condition, defined as ‘the rotation of the uterus of >45 degrees around its longitudinal axis, being dextrorotary in two-thirds of cases’ [ 1 ]. Due to its aspecific clinical presentation and often per-operative diagnosis, it has been observed more in the gravid than in the non-gravid uterus.…”

Section: Introductionmentioning

confidence: 99%

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Gravid uterine torsion after prone positioning in SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome

Hendriks

Uitert

Schoenmakers

et al. 2022

Journal of Surgical Case Reports

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A multiparous pregnant patient was admitted to the intensive care unit in her third trimester of pregnancy for prone positioning mechanical ventilation after developing SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome. Repositioning in left lateral tilt was followed by uterine contractions and cardiotocography alterations. Preterm caesarean section was performed based on persistent foetal tachycardia and suspected foetal distress, followed by a per-operative diagnosis of uterine levotorsion. This case report is the first to explore a potential causal link between prolonged prone positioning in late pregnancy and postural gravid uterine torsion and highlights the need for appropriate foetal monitoring during prone positioning mechanical ventilation support.

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“…Almost all cases of uterine torsion described in the literature were associated with preexisting gynecologic conditions, such as uterine leiomyoma, congenital anomalies, adnexal mass, or fetal malpresentation [9]. Congenital uterine anomalies, which affect 1 in 201 women in the general population and are present in 1 in 594 fertile women, was one of the identified risk factors [10].…”

Section: Discussionmentioning

confidence: 99%

Uterine torsion in a 25-week pregnant female with congenital uterine didelphys and intraoperative complication of uterine atony: a report of a rare clinical case

Chau,

Le,

Tran

et al. 2021

Clin. Exp. Obstet. Gynecol.

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Uterine torsion is an extremely rare pregnancy-related complication. Its diagnosis is o ten di ficult due to unspecific clinical symptoms, which can be mistaken for other conditions such as placental abruption. A 23-year-old pregnant woman with gestational age of 25 weeks presented with acute abdominal pain and hypertonic uterus. Vaginal examination revealed a septated vagina, double cervix, and double uterus. Bedside sonography revealed absence of fetal cardiac activity and signs of placental abruption. The patient was emergently operated with a preliminary diagnosis of severe placental abruption in the uterus didelphys. During surgery, we noted a double uterus and the fetus had implanted in the right uterus, which was twisted 180 degrees to the le t. A ter detorsion, a low transverse hysterotomy was performed to extract the dead fetus. However, subsequently, the patient developed uterine atony. Subtotal hysterectomy and right adnexectomy were inevitable due to failure of conservative treatment with B-lynch suture. The patient's postoperative condition was stable, and she was discharged a ter 5 days.

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Uterine torsion: A review with critical considerations for the obstetrician and gynecologist

Cited by 16 publications

References 45 publications

The twisted uterus: A rare presentation of uterine torsion

The twisted uterus: A rare presentation of uterine torsion

Gravid uterine torsion after prone positioning in SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome

Uterine torsion in a 25-week pregnant female with congenital uterine didelphys and intraoperative complication of uterine atony: a report of a rare clinical case

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