Ayman Khalil Othman Al Tarifi, Nafees Akhtar, Aladin Alhadi Alamri.
Uterine Torsion, Leading to Posterior Uterine Wall Incision at Cesarean Section.
J Islamic Int Med Coll Jan ;16(3):200-1.

Any rotation of uterus along its long axis which is more than 45 degrees at the junction between corpus and 1,2 cervix [Figure 1] is called uterine torsion. Torsion of uterus is a rare phenomenon, and the true pathogenesis 3 of the condition is still not clear. Here we present a case of complete uterine torsion in a 37-year-old lady who underwent cesarean section at 39 weeks of gestation due to oblique lie. This patient had two small uterine fibroids and, in the past, she had right salpingectomy for right tubal pregnancy. Intra-operatively, due to complete torsion of uterus, inadvertently incision was given in the posterior wall of uterus considering it as anterior wall, but hemostasis was successfully secured and post operatively patient recovered well. This case illustrates that while doing cesarean section on gravid uterus especially in the background of previous pelvic surgery and in the presence of fibroids, obstetricians must exercise caution to identify torsion of uterus which is through a rare but significant uterine pathology that can cause incorrect posterior uterine wall incision.

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