Twin Tragedy Averted Too Late Case Study on Hemorrhagic Shock from Irreducible Uterine Torsion

Introduction: Uterine torsion is a rare but potentially catastrophic condition in obstetrics. In a dramatic case recently documented, a 29-year-old woman experienced a severe hemorrhagic shock due to irreducible uterine torsion during her third-trimester twin pregnancy. The outcome was tragically fatal for both the mother and her unborn children, emphasizing the critical need for rapid diagnosis and emergency intervention. Visit https://www.obstetricgynecoljournal.com for more groundbreaking research in this field.

Understanding Uterine Torsion in Pregnancy

• Uterine torsion involves rotation of more than 45 degrees around the uterus’s longitudinal axis.
• Most commonly occurs in the third trimester, with risk factors including multiparity, uterine fibroids, multiple gestations, and uterine anomalies.
• Symptoms vary from mild abdominal discomfort to severe shock, and in some cases, it may be asymptomatic until surgical discovery.

Case Highlights

• The patient was in her third trimester (36 weeks) with a dichorionic diamniotic twin pregnancy.
• Presented with abdominal pain, hypotension (BP 80/40 mmHg), severe anemia (Hb 4.8), and rapid neurological decline.
• Emergency surgery revealed a 180-degree torsion with massive intrauterine hemorrhage.
• Despite surgical interventions, including cesarean hysterectomy and massive transfusions, the patient developed multi-organ failure and died post hepatic transplant.

Clinical Implications This case sheds light on the importance of early imaging and clinical suspicion in high-risk pregnancies. Although the condition is rare, clinicians should be aware of its signs, especially in multiparous women with multiple gestations.

External Expert Insight: The American College of Obstetricians and Gynecologists (ACOG) recommends prompt surgical evaluation in unexplained third-trimester abdominal pain and hemodynamic instability, supporting the urgency portrayed in this case.

Why This Research Matters This case is among the very few reported uterine torsions in twin pregnancies. It emphasizes the role of swift diagnosis in preventing maternal and fetal deaths. The full study is accessible via https://doi.org/10.29328/journal.cjog.1001055.

Explore More in Obstetric Emergencies We encourage readers to browse more rare and critical obstetric case reports and guidelines through the Clinical Journal of Obstetrics and Gynecology.

Call-to-Action: Explore more studies at https://www.obstetricgynecoljournal.com and join the conversation by sharing your thoughts in the comments below!

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