Incarcerated uterus in pregnancy – pitfalls of diagnosis, clinical course and therapy: two case reports

Czech version

Authors: Lukáš Hruban ¹; Petr Janků ¹; P. Ventruba ¹; Romana Gerychová ¹; Vít Weinberger ¹; M. Pastorčáková ¹; A. Šprláková ²
Authors‘ workplace: Gynekologicko-porodnická klinika MU a FN, Brno, přednosta prof. MUDr. P. Ventruba, DrSc., MBA ¹; Radiologická klinika MU a FN, Brno, přednosta prof. MUDr. V. Válek, CSc., MBA ²
Published in: Ceska Gynekol 2013; 78(5): 427-431
Category: Original Article

Overview

Objective:
Analysis of two cases of incarcerated uterus during pregnancy.

Design:
Two case reports.

Setting:
Department of Gynecology and Obstetrics, Masaryk University, University Hospital Brno.

Methods and results:
In two cases of incarcerated uterus, which were resolved on Department of Gynaecology and Obstetrics, University Hospital Brno is shown a different clinical course, leading to the detection and solutions at different gestational weeks. The first case was detected in 31st week of pregnancy and was characterized by nearly asymptomatic course in a pregnant woman with a scar in the lower uterine segment after a previous caesarean section. The delivery was scheduled for the end of the 36th week of pregnancy by iterative caesarean section. The second case was detected on the 27th week of pregnancy due to significant subjective difficulties of pregnant woman that impressed as acute event of abdomen. Despite all attempts at conservative therapy was necessary to terminate the pregnancy by caesarean section at 28 week of pregnancy due to the high risk of uterine rupture.

Conclusion:
Incarcerated uterus is a rare complication of pregnancy. Diagnostics complains varied clinical picture of the nonspecific subjective difficulties. Missed diagnosis can lead to a number of serious obstetric complications. In case of failure of conservative therapy and progression of difficulties is necessary to think about the real risk of uterine rupture. Before performing a caesarean section is essential knowledge of the mutual position of the lower uterine segment, urinary bladder and cervix.

Keywords:
retroverted uterus – uterine incarceration – uterine rupture – magnetic resonance imaging

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