ABSTRACT
BACKGROUND: An incarcerated uterus refers to the retroversion of a pregnant uterus within the pelvis due to the absence of a forward tilt at the end of the first trimester. An incarcerated uterus that is overlooked or only discovered perpartum can cause severe obstetrical complications. Several authors have shared their experience with uterine incarceration management at 12, 14, and 16 weeks of amenorrhea. CASE: Our report concerns a case of uterine incarceration management at 21 weeks of amenorrhea, achieved by way of a specific anesthesia protocol and the positioning of the patient, which allowed the disimpaction of the uterus with the help of external maneuvers. No recurrence was observed. CONCLUSION: Uterine incarceration management is possible beyond 16 weeks of amenorrhea.
Background: An incarcerated uterus refers to the retroversion of a pregnant uterus within the pelvis due to the absence of a forward tilt at the end of the first trimester. An incarcerated uterus that is overlooked or only discovered perpartum can cause severe obstetrical complications. Several authors have shared their experience with uterine incarceration management at 12, 14, and 16 weeks of amenorrhea. Case: Our report concerns a case of uterine incarceration management at 21 weeks of amenorrhea, achieved by way of a specific anesthesia protocol and the positioning of the patient, which allowed the disimpaction of the uterus with the help of external maneuvers. No recurrence was observed. Conclusion: Uterine incarceration management is possible beyond 16 weeks of amenorrhea.
Subject(s)
Musculoskeletal Manipulations/methods , Patient Positioning/methods , Pregnancy Complications , Propofol/administration & dosage , Succinylcholine/administration & dosage , Uterine Retroversion , Adult , Anesthetics, Intravenous/administration & dosage , Female , Humans , Magnetic Resonance Imaging/methods , Neuromuscular Depolarizing Agents/administration & dosage , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/therapy , Pregnancy Trimester, Second , Treatment Outcome , Uterine Retroversion/diagnosis , Uterine Retroversion/therapyABSTRACT
Incarceration of the gravid uterus may pose significant risks to both maternal and fetal health. Anesthetic management for these patients is variable, and the ideal anesthetic technique is unknown. The patient presented to the labor and delivery unit with pelvic pain and urinary retention in the setting of a gravid incarcerated uterus. Previous attempts at manual reduction in the outpatient setting were unsuccessful. A combined spinal-epidural anesthetic was administered, followed by spontaneous resolution of the incarcerated uterus. In addition to providing analgesia, neuraxial blockade may occasionally be an adequate therapeutic technique for reduction of a gravid incarcerated uterus.
Subject(s)
Analgesics/administration & dosage , Obstetric Labor Complications/therapy , Uterine Retroversion/therapy , Adult , Analgesics/therapeutic use , Anesthesia, Epidural , Anesthesia, Spinal , Female , Humans , Nerve Block , PregnancyABSTRACT
We will present the fourth case in the English-language literature of a mid-gestational colonoscopy-assisted manual reposition of an incarcerated uterus. Despite the ready availability of ultrasound, a great number of incarcerations are not recognized before term. Since early diagnosis is the key to a successful treatment, it is important that providers acquire prompt knowledge of this obstetric disorder. Magnetic Resonance Imaging has an important additional value to ultrasound in the detailed scanning of this potentially perilous condition.
Subject(s)
Magnetic Resonance Imaging , Pregnancy Complications/pathology , Pregnancy Complications/therapy , Uterine Retroversion/pathology , Uterine Retroversion/therapy , Adult , Female , Humans , Musculoskeletal Manipulations , Pregnancy , Pregnancy Complications/diagnostic imaging , Sigmoidoscopy , Ultrasonography , Uterine Retroversion/diagnostic imagingABSTRACT
Acute urinary retention at first trimester of pregnancy are uncommon, but have to alert the physician on the possibility of an incarcerated retroverted uterus. Through the management of iterative acute urinary retention before 18weeks of gestation with an incarcerated uterus and a review of the literature, we are going to see the various aetiologies, particularly gravid incarcerated uterus. Acute urinary retention during pregnancy is an emergency. Vaginal operations to open up the uterus should be tried at premature terms, successfully in most of cases.
Subject(s)
Pregnancy Complications/diagnosis , Urinary Retention/diagnosis , Urinary Retention/etiology , Uterine Retroversion/complications , Uterine Retroversion/diagnosis , Adult , Female , Gestational Age , Humans , Pregnancy , Pregnancy Complications/therapy , Pregnancy Outcome , Urinary Retention/therapy , Uterine Retroversion/therapyABSTRACT
The treatment of mid-gestational uterine incarceration remains a challenge. The success rate of manual reduction decreases with gestational age, and an operative procedure may carry important fetal, next to possible maternal morbidities. We will present four cases of uterine incarceration between the 15th and 25th week of pregnancy of which three colonoscopy-assisted manual repositions proved successful. It illustrates that conservative treatment of uterine incarceration is feasible, even during the late second trimester. That is why a review of the conservative approach of this rare condition is also presented.