gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Torsion of the uterus with myoma in pregnant on in 14th hbd.


Abstract

Author(s): DOBROSŁAWA L. SIKORA-SZCZĘŚNIAK, GRZEGORZ SZCZĘŚNIAK, WACŁAW SIKORA

Introduction. Uterine torsion is defined as a rotation of more than 45o around the long axis of the uterus; 2/3 cases are right turn rotations. The extent of rotation usually ranges from 45° to 180°, although there were cases reaching 720° rotation. The Aim. The purpose of the article was to present a case of uterine torsion in the pregnant patient operated on in 14th hbd, first pregnancy. Material and methods. Case history of the patient hospitalized in 13th hbd was analysed. During the operation a 180°- right turn rotation with additional myoma of the pregnant uterus was found. The patient was admitted to hospital for abdominal pains lasting for three days that increased temporarily. As the symptoms persisted, laparotomy was performed as a life-saving measure. The operation found pregnant uterus rotated towards the right by 180° and subse rous myoma located at the right margin of the uterine body mimicking the tumor of the left ovary. Results. The uterus derotated spontaneously, during palpation. The myoma was enucleated using conventional technique, the bed was tightly sutured in two layers. The patient was released from hospital on 7th day following the operation in good condition and intact pregnancy. She delivered spontaneously in 38hbd. Conclusions. The causes of pain localized in the small pelvis and abdominal cavity always need to be explored. Certain rare causes likely to account for pains have to be considered, too as they are health- and life-threatening for pregnant woman. Treatment that is promptly implemented can bring successful results, both for mother and her fetus and allows to spare woman’s fertility