Obstetrics & Gynecology Science (Sep 2018)

Incarceration of early gravid uterus with adenomyosis and myoma: report of two patients managed with uterine reduction

  • Hee-Sun Kim,
  • Ji-Eun Park,
  • Seo-Yeon Kim,
  • Jung-Eun Kim,
  • Su-Hyun Chae,
  • In-Sook Sohn,
  • Han-Sung Hwang,
  • Han-Sung Kwon

DOI
https://doi.org/10.5468/ogs.2018.61.5.621
Journal volume & issue
Vol. 61, no. 5
pp. 621 – 625

Abstract

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Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encountered two unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2 weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterine incarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infant at term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acute urinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chest position. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, the fetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for the fetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain, is important in the early gestation period.

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