Incarceration of the Gravid Uterus

Shnaekel, Kelsey L; Wendel, Michael; Rabie, Nader; Magann, Everett F.

doi:10.1097/ogx.0000000000000362

Cited by 31 publications

(51 citation statements)

References 36 publications

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“…It is recommended to restore the uterine polarity earlier in pregnancy, but reduction is not recommended after 20 weeks’ gestation unless the patient is significantly symptomatic. [4,5] In the current case, myomectomy was performed owing to unbearable pain. Incarcerated uterus was not corrected at the time of myomectomy as the clinicians were unaware of the issue.…”

Section: Discussionmentioning

confidence: 91%

Spontaneous reduction of an incarcerated gravid uterus after myomectomy in the second trimester

Tong

Wang²,

Liu³

et al. 2019

Medicine

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Rationale:During a normal pregnancy, in the 1st trimester uterus lies in pelvis and enlarges in size as the pregnancy advances. By 14 weeks of gestation, the gravid uterus transforms from a pelvis to an abdominal organ and a retroverted uterus will correct as the fundus rises out of the pelvis and falls forward to its normal anatomical position. If the uterus remains in the pelvic cavity after 14 weeks of gestation, it is referred to as an incarcerated uterus.Patient concerns:A 31-year-old gravida 3 para 0 woman was admitted to our obstetrics unit at 20 weeks’ gestation with the complaint of severe persistent upper abdominal pain for over 12 hours.Diagnosis and interventions:A diagnosis of fibroid degeneration was made through ultrasound and magnetic resonance imaging. The patient was hospitalized with conservative treatment. An abdominal myomectomy was performed at 22 weeks’ gestation because her condition had deteriorated. Incarcerated uterus was not suspected even at the time of myomectomy. But within 24 hours after myomectomy, diagnosis of incarcerated gravid uterus was made by ultrasound.Outcomes:Incarcerated gravid uterus was found spontaneously reduced three weeks after myomectomy by ultrasound. A transverse Cesarean incision was performed at 32 weeks’ gestation. A male infant weighing 2120 g was delivered with Apgar scores of 10 and 10 at 1 and 5 minutes, respectively. Postoperative course was uneventful.Lessons:Incarceration of the gravid uterus is relatively rare and it is difficult to diagnose. This patient's findings suggested the incarceration of gravid uterus can be a transient abnormal position. The results of this study indicates that the incarcerated uterus when associated with fibroid is spontaneously reduced after removal of the fibroid.

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Section: Discussionmentioning

confidence: 91%

Spontaneous reduction of an incarcerated gravid uterus after myomectomy in the second trimester

Tong

Wang²,

Liu³

et al. 2019

Medicine

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“…AUR can have a variety of clinical manifestations. According to the available data, the most common symptoms of AUR during pregnancy are urinary incontinence, incomplete urination, vaginal bleeding, miscarriage, painful urination, rectal compression, and constipation [ 4 , 9 ]. However, rare symptoms such as lower extremity swelling, severe hypertension, hydronephrosis, and asymptomatic AUR are easily overlooked during consultation [ 2 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Urinary Retention in the First-trimester of Pregnancy: A Case Report

Dai¹,

Peng²,

Chen³

2022

Cureus

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Acute urinary retention (AUR) is a rare occurrence during pregnancy. If not dealt with in time, it can lead to bladder rupture, miscarriage, or even uterine rupture and other serious consequences that endanger the health of both mother and fetus. Many risk factors have been identified. To better understand the etiology and treatment of urinary retention during pregnancy, we report on one pregnant woman with AUR who presented at 11+1 weeks of gestation due to uterus retroversion.

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“…The recommended route of delivery is cesarean section if the incarcerated uterus has been detected in the late second trimester or when uterine polarity cannot be corrected [ 14 ]. As the bladder of patients with an incarcerated gravid uterus is pulled higher than normal, a uterine incision should be made at a higher position for preventing injury to the bladder, cervix, and vagina [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Incarceration of early gravid uterus with adenomyosis and myoma: report of two patients managed with uterine reduction

et al. 2018

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Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encountered two unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2 weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterine incarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infant at term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acute urinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chest position. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, the fetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for the fetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain, is important in the early gestation period.

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Incarceration of the Gravid Uterus

Cited by 31 publications

References 36 publications

Spontaneous reduction of an incarcerated gravid uterus after myomectomy in the second trimester

Spontaneous reduction of an incarcerated gravid uterus after myomectomy in the second trimester

Acute Urinary Retention in the First-trimester of Pregnancy: A Case Report

Incarceration of early gravid uterus with adenomyosis and myoma: report of two patients managed with uterine reduction

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