Quirk of fate: a case report of complete uterine torsion in early third trimester

Uterine torsion is an abnormal rotation of the uterus along its fixed longitudinal or vertical axis by an angle more than 45 degrees. Uterine torsion ranges from 60 to 720 degrees with 180 degrees being the most common. Here is a 30-year-old G3P1L1A1 with singleton pregnancy with 29 weeks 2 days gestation with previous LSCS admitted in our hospital with severe pain abdomen. The pain started 4 hours back. On examination patient was hemodynamically unstable. Abdominal examination revealed a tense, tender uterus with absent fetal cardiac activity. Clinical diagnosis of Placental abruption with intrauterine fetal demise was made. Emergency LSCS done in view of detoriating haemodynamic status under GA. Dilated and torturous pelvic vessels with couvelaire uterus noted. After extraction, while exploring the posterior aspect of the uterus, uterine torsion of 360 degrees noted. On derotation of uterus, pelvic congestion relieved and uterus started to contract and retract.