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Cesarean Delivery by Posterior Hysterotomy Due to Torsion of the Pregnant Uterus

Picone, Olivier MD1; Fubini, Alessandra MD1; Doumerc, Severin MD1; Frydman, René MD1

doi: 10.1097/01.AOG.0000187941.89604.b6
Case Report
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BACKGROUND: We describe a case of cesarean delivery by posterior hysterotomy in a woman with uterine torsion secondary to a blocked retroverted uterus.

CASE: At 28 weeks of gestation this patient’s fetus was found to have club feet, initially suspected to be secondary to sacculation of the posterior uterine segment. At cesarean delivery, intraoperative inspection revealed the uterus to be twisted 180° without evidence of posterior sacculation. The uterine incision was performed on the posterior aspect of the lower uterine segment.

CONCLUSION: Fixed uterine retroversion with torsion is associated with fetal abnormalities and may require a posterior uterine incision.

Impacted uterine retroversion during pregnancy is a differential diagnosis of posterior sacculation and can result in uterine torsion.

From the 1Service de Gynécologie-Obstétrique, Hôpital Antoine Béclère, Clamart, France.

The authors thank Professor Victor Gomel for editing this manuscript.

Corresponding author: Dr. Olivier Picone, Service de Gynécologie-Obstétrique, Hôpital Antoine Béclère, 157, rue de la porte de Trivaux, 92140 Clamart, France; e-mail: olivier.picone@abc.ap-hop-paris.fr.

© 2006 The American College of Obstetricians and Gynecologists