We present a case of 180 degree uterine rotation diagnosed in a woman at 35 weeks gestation at the time of emergency caesarean section. As with many previous reports this case presentation included acute abdominal pain, shock and fetal demise. The main differential diagnoses in this case were placental abruption and uterine rupture as she had a previous caesarean scar.
From literature review we will discuss the prevalence of such cases, the variations seen, associated risk factors, management issues and how to address some of the complications. Although rare, it is well reported. It is associated with high maternal (10-20%) and perinatal (30%) mortality rates. Previous caesarean operations appear to be a common factor further adding to the list of morbidities associated with this now very common operation. It is important to be reminded of this condition in order to aid its management and to improve outcome.
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