What does right-rotated uterus mean?

Dextrorotation of the uterus occurs in the late stages of pregnancy, and is accompanied by varying degrees of dextrorotation. This symptom is relatively common and can be slowly restored by improving the body position and making timely adjustments during sleep. Also, if you feel any discomfort, you should go to the hospital for a check-up in time. Physical changes during pregnancy are very critical.

Introduction

The pregnant uterus, especially in the late pregnancy, is accompanied by varying degrees of right rotation, but the rotation angle does not exceed 30°. If the pregnant uterus rotates more than 90° to the right or left and is accompanied by symptoms such as abdominal pain, it is called torsion of the pregnant uterus. Pregnant uterine torsion is more common in livestock due to the bicornuate uterus, but is extremely rare in humans.

Pathological changes in the pelvis are the basis for causing uterine torsion during pregnancy. Nesbitt et al. (1956) collected 107 cases of uterine torsion accompanied by symptoms reported in the literature and found that the main pathological changes in the pelvis were uterine fibroids, bicornuate uterus and transverse position, accounting for more than 60% of all cases of uterine torsion. The common feature of these three is that the weight on the left and right sides of the uterus is uneven, which makes it easy to cause torsion; the rest are ovarian tumors combined with pregnancy, pelvic adhesions, spinal deformities and other types of fetal malpositions; in about 21% of cases, there are no pathological changes in the pelvis. Sudden changes in body position, poor posture and fetal movement are often the direct causes of uterine torsion during pregnancy. [1]

Main symptoms

The main symptom of this disease is abdominal pain, and 95% of cases have abdominal pain to varying degrees. The degree of abdominal pain is proportional to the uterine ischemia caused by torsion. Therefore, the greater the degree of torsion and the longer the duration, the more severe the uterine ischemia and the more severe the abdominal pain. The degree of twisting can reach 90° or even 720°. Among the 107 cases collected by Nesbitt, 16 had torsion greater than 180°, 2/3 of which were accompanied by shock. At this time, the maternal mortality rate can be as high as 50% and the fetal and infant mortality rate can be as high as 75%. In addition, 18.7% of cases were accompanied by gastrointestinal symptoms including nausea, vomiting, abdominal pain, diarrhea, abdominal distension, etc.; 10.3% of cases were accompanied by urinary tract symptoms, including frequent urination, urgency, inability to urinate, etc.; sometimes accompanied by small to moderate vaginal bleeding. [1]

examine

During abdominal examination, there is often tenderness, rebound tenderness and muscle cramps in the abdominal wall, tenderness in the uterus, and sometimes the round ligament that turns from the side to the front, running vertically and accompanied by tenderness can be felt. If there is a tumor, a protruding mass can be felt. During pelvic examination, the vagina may become a blind end or a spiral due to torsion, with the cervix retracted above the pubic symphysis, and the pulsating uterine artery may be felt through the anterior fornix. The urethra may become spirally curved or blocked due to torsion, making catheterization difficult or even impossible. Digital examination through the anus (rectum) may also reveal varying degrees of twisting. For women in labor, the cervix may dilate to varying degrees, but uterine contractions are strong and labor is stagnant. In severe cases of torsion, blood flow obstruction may cause fetal distress, even placental abruption and fetal death. [1]