Boogaerts Matthias, Wuyts Kathleen, Joos Henri
Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
Department of Obstetrics and Gynaecology, Heilig-Hart Hospital Lier, Lier, Belgium.
Case Rep Womens Health. 2022 Aug 5;36:e00435. doi: 10.1016/j.crwh.2022.e00435. eCollection 2022 Oct.
Uterine torsion during pregnancy is a rare obstetrical complication that can be life-threatening for both mother and child. Although torsion usually presents with acute, non-specific symptoms, it can also occur without any symptoms and pose no immediate health threat. Ultimately, the diagnosis of torsion is often made only during cesarean section. We present a case of a patient who underwent two successive cesarean sections through separate posterior and anterior hysterotomy due to asymptomatic uterine torsion in both cases. During the first cesarean section an incision was inadvertently made in the posterior segment of the uterus. At the second cesarean section the degree of rotation was very different and an anterior hysterotomy was performed. The patient made an uneventful recovery after both deliveries. If access to the lower anterior uterine segment is not safely available due to uterine torsion, a hysterotomy in the lower posterior uterine segment can be performed. The risk of rupture of a posterior hysterotomy scar in future pregnancies is unclear.
妊娠期子宫扭转是一种罕见的产科并发症,对母亲和胎儿都可能危及生命。尽管扭转通常表现为急性、非特异性症状,但也可能无症状发生且不会立即对健康构成威胁。最终,子宫扭转的诊断往往仅在剖宫产时才能做出。我们报告一例患者,该患者因两次均为无症状子宫扭转,分别通过子宫后壁和前壁不同的子宫切开术进行了两次连续剖宫产。在第一次剖宫产时,无意中在子宫后壁做了切口。第二次剖宫产时,扭转程度差异很大,于是进行了子宫前壁切开术。两次分娩后患者均顺利康复。如果由于子宫扭转无法安全进入子宫下段前壁,可在子宫下段后壁进行子宫切开术。未来妊娠时子宫后壁切开术瘢痕破裂的风险尚不清楚。