Clinical approach and management of uterine incarceration according to trimester of pregnancy: Case report and literature review

Young Sun Kim, Byung Su Kwon, Young Ju Lee
In: Taiwanese Journal of Obstetrics and Gynecology · 2021 · vol. 60(5) , pp. 911–915 · doi:10.1016/j.tjog.2021.07.023 · PMID:34507673 · W3197550652
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This case report and literature review outlines the diagnosis and management of uterine incarceration, detailing a successful laparotomy for repositioning the uterus in a patient with abdominal pain and urinary dysfunction at 18 weeks gestation.

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Abstract

OBJECTIVE: The purpose of present report is an effective clinical approach to incarcerated uterus by the trimester of pregnancy, in this case and 54 cases reported previously. CASE REPORT: A woman at 18 + 5 weeks of gestation was referred with abdominal pain and urinary dysfunction. In pelvic examination, the cervix was not seen and huge myoma was located at retroverted anterior uterine wall and the elongated cervix was pulled up above the bladder in ultrasonography. The uterine incarceration was confirmed by magnetic resonance imaging. The manual reduction of uterus was attempted with knee-chest-position repeatedly. However, this was unsuccessful because large fibroid was impacted and immovable. Therefore, laparotomy was conducted for repositioning of uterus. Pregnancy was maintained without any complication and a 4250 g healthy female infant was delivered by cesarean section. CONCLUSION: By analyzing of several cases, useful diagnostic modalities and effective management should be approached according to trimester of pregnancy.

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