Objective: The aim of this review was to describe the risk factors, clinical and radiographic criteria, and management of this rare complication of pregnancy.
Methods: A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched.
Results: There were 60 articles identified, with 53 articles being the basis of this review. Multiple risk factors have been suggested in the literature including retroverted uterus in the first trimester, deep sacral concavity with an overlying sacral promontory, endometriosis, previous abdominal or pelvic surgery, pelvic or uterine adhesions, ovarian cysts, leiomyomas, multifetal gestation, uterine anomalies, uterine prolapse, and uterine incarceration in a prior pregnancy. The diagnosis is difficult to make owing to the nonspecific presenting symptoms. The diagnosis is clinical and confirmed by imaging. Magnetic resonance imaging is superior to ultrasound to accurately diagnose and elucidate the distorted maternal anatomy. Treatment is dictated by gestational age at diagnosis based on risks and benefits. The recommended route of delivery is cesarean delivery when uterine polarity cannot be corrected.
Conclusions: Incarceration of the gravid uterus is a rare but serious complication of pregnancy. The diagnosis is clinical and confirmed with imaging, with magnetic resonance imaging being superior to delineate the distorted maternal anatomy. Reduction of the incarcerated uterus should be attempted to restore polarity and avoid unnecessary cesarean delivery.
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http://dx.doi.org/10.1097/OGX.0000000000000362 | DOI Listing |
J Clin Ultrasound
September 2024
Department of Ultrasound, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Objective: To summarize the ultrasound characteristics, diagnostic experiences, and pregnancy outcomes of gravid uterine incarceration.
Methods: A retrospective analysis was conducted on the data of pregnant women diagnosed with gravid uterine incarceration by prenatal ultrasound at the Ultrasound Department of the Third Affiliated Hospital of Zhengzhou University from January 2020 to December 2023. Clinical data, ultrasound features, and pregnancy outcomes were analyzed.
J Clin Ultrasound
January 2025
Department of Ultrasound, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.
J Int Med Res
September 2024
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China.
Incarceration of the gravid uterus is a rare and serious obstetric complication that can lead to severe complications. We present the case of a 32-year-old woman (gravida 5, para 2022) at 12 weeks and 5 days of gestation who presented with urinary retention and lower abdominal pain. Despite attempts at positional changes and manipulative repositioning under epidural anesthesia, the incarceration of the gravid uterus persisted.
View Article and Find Full Text PDFAm J Obstet Gynecol
August 2024
Department of Obstetrics and Gynecology, NYU Langone Hospital-Long Island, NYU Grossman Long Island School of Medicine, Mineola, NY.
Background: 'Incarcerated gravid uterus' is a morbid complication that occurs in 1 in 3000 pregnancies. It is characterized by failure of a retropositioned uterus to become an abdominal organ between 12 to 14 weeks of gestation. If maternal symptoms develop or gestational age surpasses 14 to 16 weeks, replacement of a retropositioned uterus is recommended to reduce adverse outcomes.
View Article and Find Full Text PDFQuant Imaging Med Surg
May 2024
Department of Neurology, Northwestern Memorial Hospital, Northwestern University, Chicago, IL, USA.
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