Time is of the essence: an acute complete uterine torsion in a 27-week pregnancy

Uterine torsion is a rare but critical obstetrical emergency that demands prompt diagnosis and intervention to optimise maternal and fetal outcomes. This case describes acute uterine torsion in a 27-week gestation patient, who presented with sudden onset abdominal pain and fetal distress. An emergency caesarean section was performed. A 360° levorotated uterus with a compromised lower segment was found. The uterus was rotated back to its anatomical position, and the fetus was delivered via a low vertical uterine incision. This report serves to increase awareness of uterine torsion as a differential diagnosis in obstetrical emergencies and provides a brief review of the literature on uterine torsion in a gravid uterus.