Cesarean delivery by posterior hysterotomy due to torsion of the pregnant uterus.

Background: We describe a case of cesarean delivery by posterior hysterotomy in a woman with uterine torsion secondary to a blocked retroverted uterus.

Case: At 28 weeks of gestation this patient's fetus was found to have club feet, initially suspected to be secondary to sacculation of the posterior uterine segment. At cesarean delivery, intraoperative inspection revealed the uterus to be twisted 180 degrees without evidence of posterior sacculation. The uterine incision was performed on the posterior aspect of the lower uterine segment.

Conclusion: Fixed uterine retroversion with torsion is associated with fetal abnormalities and may require a posterior uterine incision.