Incidental posterior uterine incision for caesarean section following uterine torsion: A case report

Calistus Obiora NEVO 1, 3, *, Livinus Nnanyelugo ONAH 1, 3, Ifeanyi Johnson ONYEKPA 1, 3, Malachy Nweze EZENWAEZE 1, 3, Anayo Innocent UGWU 1, 3, Chikezie Jude OKAMKPA 2, Sylvester Onuegbunam NWEZE 1, 3, Chike Joachim MADUKA 3, Sunday Gabriel MBA 1, 3, Fredrick Ikenna AWKADIGWE 3, OKOH Darlington Sunday 3, Kelvin Emeka ORTUANYA 1, 3, EZENYIROHA Ugochukwu 3, Nnanyelugo Chima EZEORA3, Benedicta Ezinne ANEKE 3, Thaddeus Ogbonna OFFOR 3, Obumneme Nkemakolam CHUKWUBIKE 3, Ernest UZOHO 3, Enoch Ejiofor OGBONNA 3, Chibunze Chukwunonso UDEGBUNAM 3, Ugochukwu Daniel UMEKWE 3, Obiechina Chijioke EZE 3, Chukwuka Chude EZE 3, Chika Thompson UGWUANYI 3, Ugochukwu Godwin EMMANUEL 3 and Ifeoma Rose OZOR 4

1 Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology, Enugu.
2 Department of Human Anatomy, Faculty of Basic Medical Sciences, Enugu State University of Science and Technology, Enugu.
3 Department of Obstetrics and Gynaecology, ESUT Teaching Hospital, Enugu.
4 Department of Anaesthesia, ESUT Teaching Hospital, Enugu.
 
 
Case Report
World Journal of Advanced Pharmaceutical and Medical Research, 2025, 08(02), 001-006.
Article DOI: 10.53346/wjapmr.2025.8.2.0023
Publication history: 
Received on 13 February 2025; revised on 02 April 2025; accepted on 05 April 2025
 
Abstract: 
Uterine torsion in a term pregnancy is an exceedingly rare, potentially hazardous occurrence with high risk of perinatal mortality and morbidity. Diagnosis is almost always intraoperative during caesarean section and it is usually unexpected.
We present a very unusual case of 180o uterine torsion noticed intraoperatively during an elective caesarean section indicated by recurrent breech presentation at term in a background of previous caesarean section. Intraoperatively, caesarean section was complicated by cardiac arrest from high spinal anaesthesia, while delivery was effected through a posterior transverse almost mid-segment incision after attempt at uterine detorsion was not feasible. The patient was revived and a live female baby that weighed 2.7kg with APGAR scores of 5 and 10 in the first and fifth minutes respectively was extracted. Her post operative condition was uneventful and she was discharged on the 3rd post operative day.
 
Keywords: 
Torsion; Uterus; Posterior Incision; Caesarean Section
 
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