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Case Reports
. 2022 Jun 24;2022(6):rjac289.
doi: 10.1093/jscr/rjac289. eCollection 2022 Jun.

Gravid uterine torsion after prone positioning in SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome

Bavo Hendriks  1 , Evelyne van Uitert  2 , Sam Schoenmakers  2 , Johannes J Duvekot  2 , Diederik Gommers  3 , Jérôme M J Cornette  2 ; COVPREG Study Group
Collaborators, Affiliations
Case Reports

Gravid uterine torsion after prone positioning in SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome

Bavo Hendriks et al. J Surg Case Rep. .

Abstract

A multiparous pregnant patient was admitted to the intensive care unit in her third trimester of pregnancy for prone positioning mechanical ventilation after developing SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome. Repositioning in left lateral tilt was followed by uterine contractions and cardiotocography alterations. Preterm caesarean section was performed based on persistent foetal tachycardia and suspected foetal distress, followed by a per-operative diagnosis of uterine levotorsion. This case report is the first to explore a potential causal link between prolonged prone positioning in late pregnancy and postural gravid uterine torsion and highlights the need for appropriate foetal monitoring during prone positioning mechanical ventilation support.

Keywords: SARS-CoV2 (COVID-19); acute respiratory distress syndrome; pregnancy; prone positioning; uterine torsion.

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Figures

Figure 1
Figure 1
Per-operative diagnosis of uterine levotorsion: right adnexal view with congestion of the para-uterine vascular plexus.
See this image and copyright information in PMC

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