Asymptomatic Torsion of a Leiomyomatous Gravid Uterus at Term

Mai Mohamed Alhassan, Faisal Basama, Amir Elnahas, Rabeaa Ahmed Hasanin Saad and Elmutawkil Billah Gubara

Department of Obstetrics and Gynaecology, Hamad Medical Corporation, Qatar
Department of Obstetrician and Gynaecologist, Weill Cornell Medical College, Qatar
Department of Obstetrician and Gynaecologist, Sidra Medical and research Center, Qatar

^*Correspondance to: Faisal Basama 

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Abstract:

Background: We are reporting a case of torsion of a gravid uterus. This is a rare occurrence and the non-specific clinical course of the condition make prospective diagnosis difficult and raises some management challenges; however, the diagnosis should be suspected if the uterus contains leiomyomata, especially if complications arise or if abnormal anatomy is detected during caesarean section. In this case, the distorted anatomy during an emergency caesarean section has guided the operator to the diagnosis of uterine leiomyomata causing asymptomatic 180 degrees uterine torsion in pregnancy, and led to the correction of the anomaly prior to the caesarean section.Method: This is a retrospective and descriptive case report.Conclusion: Uterine torsion can be asymptomatic. The operator should always ascertain the pelvic anatomy before incising the uterus. We hypothesize that the severe uterine torsion might have compromised the uterine and placental blood flow, and made the fetus not withstand the challenge of mild uterine contractions.

Keywords:

Leiomyoma; Gravid uterus; Uterine rotation; Uterine torsion; Caesarean section

Cite the Article:

Alhassan MM, Basama F, Elnahas A, Saad RAH, Gubara EB. Asymptomatic Torsion of a Leiomyomatous Gravid Uterus at Term. Ann Clin Case Rep. 2016; 1: 1180.