October 2017 · Volume 6 · Issue 10 Page 4700 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Anne S et al. Int J Reprod Contracept Obstet Gynecol. 2017 Oct;6(10):4700-4702 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Report Asymptomatic levo uterine torsion of 90 degrees during caesarean section Sirisha Anne 1 *, Arpit Garg 2 , Debraj Sen 3 INTRODUCTION Uterine torsion is a complication rarely encountered by the obstetrician, often not being diagnosed until just before or just after delivery at caesarean section. It is associated with morbidity and mortality both for the mother and the baby. The etiology of uterine torsion in most cases is unknown. Literature search suggests case reports only and mostly experiencing 180 degrees rotation of the uterus. 1 Uterine torsion in many case reports suggests dextro rotation whereas in our case it was levotorsion of 90 degrees which has not been reported till date. It has been studied to be associated with fetal compromise also. Perinatal mortality has been reported to be around 12 % and occasional maternal mortality reported. 2 Only in about 16% cases cause has not been associated, the other causes associated with torsion were uterine asymmetry, uterine anomalies, and severe adhesions from pelvic surgeries. 1 CASE REPORT A 29-year-old lady, G3P1L1A1, at 35W5D POG was admitted with complaints of pain abdomen and low back ache since one day. Her first pregnancy was a spontaneous abortion at 12 weeks. Second pregnancy was two years ago when she underwent emergency LSCS at term for non progress of labour and delivered a baby with birth weight of 3 kg However during the previous LSCS there was no history suggesting she had uterine torsion intraop. Her pregnancy had been uneventful throughout with no any other co morbidities. At admission, her vitals were stable and abdominal examination revealed abdomen unusually distended with cephalic position of the fetus and uterus was relaxed. NST was reactive. She was observed in the ward for monitoring of her labour. The next day patient complained of increased abdominal discomfort. Her examination then showed that she had ABSTRACT Uterine torsion is defined as a rotation of uterus more than 45 degrees along it’s long axis. Some degree of dextrorotation in the gravid uterus can be a normal finding, however rotation greater than 45 degrees along the longitudinal axis of the uterus which is described as uterine torsion is a rare pathological condition in obstetrical practice. We report a case of levotorsion of the uterus by 90 degrees wherein patient had presented with pre term labour at 35W5D POG and levotorsion was encountered and managed intraop during caesarean. Uterine torsion of 90 degrees was encountered with the round ligament and tubo ovarian complex along with the uterine artery lying anteriorly at the incision site and lower segment of uterus rotated laterally onto the right side. The surgery was handled diligently resulting in average blood loss. Blood loss during the surgery was average. After the delivery of the baby, uterus returned to anatomical position and levotorsion corrected spontaneously. Keywords: Caesarean, Levotorsion of uterus in pregnancy, Uterine torsion 1 Department of Obstetrics and Gynecology, 2 Department of Anaesthesiology, 3 Department of Radiology, Armed Forces Medical College, Pune, Maharashtra, India Received: 07 August 2017 Accepted: 31 August 2017 *Correspondence: Dr. Sirisha Anne, E-mail: siri1407@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174468