Abnormal uterine position during pregnancy secondary to abdominal surgery: Two case reports

Abstract

Rationale:The umbilical cord is the way to exchange gas, supply nutrients, excrete metabolized. Thrombosis of the umbilical cord leads to fetal hypoxia, which jeopardizes fetal health and can cause fetal death. Umbilical vessel thrombosis, which is rarely reported, is difficult to detect prenatally.Patient concerns: Both individuals included in this study had a history of abdominal operation before pregnancy. The abnormal uterine position demonstrated in the first patient developed secondary to adhesions between the anterior bladder wall and lower segment of the uterus. As the uterus increased in size in proportion with the gestational age, the uterine body continued to enlarge even as the lower uterine segment remained fixed by the adhesions, which resulted in cervical displacement. In comparison, the abnormal uterine position in the second patient was due to a rare case of uterine incarceration developed.Diagnosis: Both cases were diagnosed as abnormal uterine position during pregnancy secondary to abdominal surgery. Interventions:The first patient underwent a cesarean section at 33 weeks and 5 days age of gestation for pregnancy complications. The second patient performed a cesarean section at 37 weeks age of gestation.Outcomes: Due to reasonable treatment, the 2 cases achieved good maternal-infant outcomes. Conclusion:Abnormal uterine position during pregnancy should be considered seriously, because it can affect the prognosis of the mother and child. When appropriate, a cesarean section is an effective method for terminating such pregnancies. During cesarean section, a longitudinal skin incision may be more beneficial in avoiding secondary injuries. However, the choice of uterine incision should be adjusted for each patient. Care should be given to prevent postpartum hemorrhage.