A rare case of torsion of a gravid uterus with delivery through inadvertent posterior lower segment uterine incision with favorable outcome: A case report

We report a case of 32yr old primigravida with persistent breech presentation at term that had an elective lower segment caesarean section at 38 weeks 3 days gestation. Having gained access into the peritoneal cavity, the utero-vesical peritoneal reflection could not be accessed in an apparently grossly normal gravid uterus, coupled with indwelling catheter draining clear urine. Kerr’s lower segment incision was made after correcting dextrorotation and the baby and subsequently the placenta were delivered. The incision was repaired in double layers. Exploration revealed a uterus that rotated 180 degrees, with the left fallopian tube and ovaries occupying right iliac fossa and vice versa. It was then de-rotated, thereby alerting our attention to the accidental posterior lower segment incision. The patient’s immediate postoperative conditions remained satisfactory and was discharged on the 5th postoperative day having made smooth recovery.