How to avoid complications in cases of incarcerated gravid uterus diagnosed in the third trimester

• Published in: Journal of Japan Society of Perinatal and Neonatal Medicine Vol. 58; no. 2; pp. 334 - 340
• Main Authors: Okura, Yoshinori, Kobayashi, Kosuke, Shimizu, Haruhiko, Maruyama, Yosuke
• Format: Journal Article
• Language: Japanese
• Published: Japan Society of Perinatal and Neonatal Medicine 2022; 一般社団法人 日本周産期・新生児医学会
• Subjects: incarcerated gravid uterus; retroverted gravid uterus; uterine incarceration; uterine sacculation
• ISSN: 1348-964X; 2435-4996
• DOI: 10.34456/jjspnm.58.2_334

Incarcerated gravid uterus is uncommon but serious condition in pregnancy, in which retroverted uterus is trapped in the pelvic cavity and causes severe complications. Persistent incarceration in the third trimester is even more rare. We experienced 4 cases of asymptomatic incarcerated gravid uterus in the third trimester in ten years. Myoma was the cause in 3 cases, and adhesion in the fourth case. None of them were able to expose the cervix, and MRI showed highly retroverted uterus in every case. Cesarean section was chosen in all cases as delivery method, and we conducted intra-operative ultrasound exam to determine the site of incision of the uterine wall. By suspecting incarcerated uterus from physical examination, and deciding delivery and surgical method regarding diagnostic imaging, we managed to avoid severe complications in cesarean section.