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

• Published in: Obstetrics & gynecology science Vol. 61; no. 5; pp. 621 - 625
• Main Authors: Kim, Hee-Sun, Park, Ji-Eun, Kim, Seo-Yeon, Kim, Jung-Eun, Chae, Su-Hyun, Sohn, In-Sook, Hwang, Han-Sung, Kwon, Han-Sung
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society 01.09.2018; Korean Society of Obstetrics and Gynecology; 대한산부인과학회
• Subjects: Case Report; myoma; pregnancy; retroversion; uterine disease; 산부인과학; Pregnancy; Uterine disease; Myoma; Retroversion
• ISSN: 2287-8572; 2287-8580
• DOI: 10.5468/ogs.2018.61.5.621

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.