Incidental posterior uterine incision for caesarean section following uterine torsion: A case report

Uterine torsion in a term pregnancy is an exceedingly rare, potentially hazardous occurrence with high risk of perinatal mortality and morbidity. Diagnosis is almost always intraoperative during caesarean section and it is usually unexpected. We present a very unusual case of 180o uterine torsion noticed intraoperatively during an elective caesarean section indicated by recurrent breech presentation at term in a background of previous caesarean section. Intraoperatively, caesarean section was complicated by cardiac arrest from high spinal anaesthesia, while delivery was effected through a posterior transverse almost mid-segment incision after attempt at uterine detorsion was not feasible. The patient was revived and a live female baby that weighed 2.7kg with APGAR scores of 5 and 10 in the first and fifth minutes respectively was extracted. Her post operative condition was uneventful and she was discharged on the 3rd post operative day.