A retroverted gravid uterus occurs when the uterus is tilted backwards during early pregnancy, which can lead to an incarcerated uterus if not resolved by 12 weeks. This can be caused by pre-existing factors such as pelvic tumors or fibroids, and symptoms include lower back pain and urinary difficulties. Treatment involves draining the bladder and repositioning the uterus. Left untreated, it can lead to serious complications such as thinning of the uterine wall and fetal membranes, bladder rupture, and miscarriage.
During early pregnancy, the uterus is normally tilted forward before lifting out of the pelvis, at about 12 weeks, into a relatively upright position in the abdomen. A retroverted gravid uterus occurs when the uterus is tilted backwards. This is not uncommon and the condition usually clears up on its own by the 12 week point. However, particular concerns may arise in the rare event that the situation does not resolve itself, resulting in a condition called an incarcerated uterus.
An incarcerated uterus can occur due to a number of pre-existing factors or conditions. Previous multiple pregnancies, pelvic tumors, and fibroids can all be factors. Previous conditions such as endometriosis or pelvic infections can result in adhesions, which prevent the uterus from repositioning itself properly. Finally, anatomical abnormalities that might otherwise be clinically insignificant may play a role.
The symptoms of an inverted gravid uterus can often be quite general and associated with a normal pregnancy. This can include lower back pain, pelvic discomfort, and rectal pressure, including a strong desire to pass stool while suffering from progressive constipation. Urinary difficulties are the most common complaint, including an increased urge to urinate but an inability to do so, resulting in cystitis. This generally raises a red flag if the woman is only three to four months pregnant.
On examination, the incarcerated gravid uterus can be identified by a distended bladder. On palpation of the abdomen, one can also feel the displacement of the cervix and the size of the uterus. The condition is usually confirmed by the use of ultrasound and MRI, which can view the location of the fetus more clearly.
Left untreated, a retroverted gravid uterus that has led to incarceration can have very serious complications. These can include thinning of the anterior uterine wall, which can later rupture during labor. Thinning can also occur in the fetal membranes, which are also vulnerable to tearing. Bladder rupture, induction of preterm labor, and miscarriage are also serious complications.
Treatment for this condition initially involves inserting a catheter to drain the bladder and reduce the pressure. The next step is to try to reposition the retroverted gravid uterus. This is often accomplished through physical manipulation by an obstetrician. Although it is usually done while the woman is awake and assisting the maneuver with pelvic rocking, if the uterus feels very still, doctors use general anesthesia and push the uterus into the correct position.
Protect your devices with Threat Protection by NordVPN
