Health Care : Current Reviews

Asymptomatic torsion of a gravid uterus

Global Healthcare & Fitness Summit

July 20-22, 2015 San Francisco, USA

Somayeh Moukhah and Firoozeh Ahmadi

Posters-Accepted Abstracts: Health Care: Current Reviews

Abstract:

Rotation of the uterus is common during pregnancy. In two-thirds of cases, there is a physiologic dextro rotation of the
uterus. Uterus rotation of more than 45 degrees is classified as pathologic but is scarcely seen in practice. Some studies
have identified abnormal or pathological conditions in the uterus or adjacent structures as the possible predisposing factors. In
16% of the cases including the one in the current report occurred without any predisposing factor. We report an asymptomatic
uterine torsion. In December in 2011, a 38 year old woman (gravida 4, para 2 and abortus 1) at the 34th week of gestation was
presented at the Prenatal Care Unit of Shahid Akbarabadi Hospital Tehran, Iran. She had pregnancy-induced hypertension
(systolic BP 170 mmHg) and she was admitted to the labor ward. According to the routine protocol of Hospital, we ordered
the following items: Laboratory tests related to pre-eclampsia, Urine analysis and 24-hour urine test, fetal non-stress test,
Betamethasone and Magnesium sulfate 20%. Because of fetal bradycardia (about 80 beats per minute, beat-to-beat variability),
She was thus taken to emergency cesarean section while injections of magnesium sulfate continued (her BP was 140/100
mmHg). After delivery we found a spontaneous uterine torsion of at least 180 degrees in the clockwise direction. Therefore,
an incision was made at the posterior uterine wall. The patient was transferred to the ICU (BP was 160/110 mmHg). Two days
later she was discharged (BP was 110/80 mmHg). The infant was in the NICU for 2 days because of LBW (1650 gr) and fetal
distress but was discharged home after 2 weeks in good condition. Although uterine torsion is a rare obstetric event, it has
non-specific symptoms and may result in severe complications. Timely and accurate preoperative diagnosis of uterus torsion
and immediate surgery are of utmost importance to save both the mother and the baby. Moreover, in order to avoid serious
vascular injuries, the uterus needs to be assessed for rotations before making any incision during a cesarean section.

Biography :

Somayeh Moukhah has completed her Bachelor’s degree at the age of 22 years from Medical Science of Tehran University and Msc from Tarbeat Modarres University
School of Midwifery. She is a Researcher of Royan Institute for Reproductive Biomedicine. She was “Scientific Select” in Tarbeat Modarres University during 2011 and
2012. One of her articles was “winner” in IRHRC congress that was held by Institution Center of Reproductive Health of Shahid Beheshti University on 22-24 January,
2015.