Uterine torsion in pregnancy

Abstract

Torsion of the gravid uterus is defined as rotation of more than 45 degrees around the long axis of the uterus. Torsion to the extent of arresting uterine circulation and causing acute abdomen is, however, rare. Torsion ranging from 60 degrees to 720 degrees has been reported. It is difficult to explain why torsion occurs but various abnormalities have been associated with this condition such as uterine fibromyoma, ovarian tumours, foetal malformations and abnormal foetal presentations. The incidence of uterine torsion in pregnancy is very rare as uptil 1992 only 212 cases have been reported in the world literature. Such cases can be mistaken for accidental haemorrhage, rupture uterus, or ectopic pregnancy depending upon the stage of gestation at which it presents. We present a case of uterine torsion at 32-week gestation which we mistook for rupture uterus. The diagnosis could be established during laparotomy.