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Torsion of the Gravid Uterus

  • Goran Augustin
Chapter

Abstract

Torsion of the gravid uterus, a frequent disorder in veterinary obstetrics, is extremely rare in humans but is more common than torsion of a nongravid uterus. Physiological dextrorotation is common in pregnancy and if additional risk factors for uterine torsion are present, such as uterine anomalies, myomas or fetal disproportions, uterine torsion has a higher incidence of occurrence. The clinical presentation of uterine torsion is variable and non-specific. Symptoms depend on the degree of torsion, the speed at which the torsion develops, duration of torsion, and stage of pregnancy, labor or puerperium. Differential diagnosis is almost always obstetric, mostly as spontaneous uterine rupture or obstructed labor. The diagnosis should be made promptly for two reasons: (1) to save the fetus, and (2) to prevent ischemic uterine changes which could lead to uterine necrosis indicating hysterectomy. Early intervention, before irreversible uterine ischemic changes, occur enable uterus preservation with the possibility of normal future pregnancies. Detorsion is always the first operative method, and if not successful hysterotomy with Cesarean delivery helps in uterine detorsion.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Goran Augustin
    • 1
    • 2
  1. 1.School of Medicine University of ZagrebZagrebCroatia
  2. 2.Department of SurgeryUniversity Hospital Centre ZagrebZagrebCroatia

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