Rotation of the uterus to obtain a lower transverse incision in the posterior wall in a cesarean section: a case report and literature review

Abstract

Objective

To demonstrate that cesarean section with a transverse incision at the lower posterior wall of the uterus is suitable for some special obstetric cases.

Case report

A 35-year-old primigravida with a previous surgical history of laparoscopic myomectomy underwent elective cesarean section at 39 weeks and 2 days of gestation. During surgery, there were severe pelvic adhesions and engorged vessels on the anterior wall. Considering safety, we rotated the uterus 180 degrees and made a lower transverse incision on the posterior wall. The infant was healthy and the patient had no complications.

Conclusions

A low transverse incision in the posterior uterine wall is safe and effective when the incision of the anterior wall encounters a dilemma, especially in patients with severe pelvic adhesions. We recommended this approach should be done in selected cases.

Keywords:

• Cesarean section
• posterior wall
• rotation
• adhesion

Acknowledgment

The authors acknowledge the hard and dedicated work of all staff members involved in the study.

Ethical approval

This study was approved by the Ethics Committee of West China Second Hospital, Sichuan University.

Consent to participate

The written patient consent for publication has been obtained.

Consent to publish

The authors affirmed that the human research participants provided informed consent for the publication of the images in all figures.

Author contributions

All authors contributed to the conception and design of this study. The first draft of the manuscript was written by An Tong, and all the authors commented on the previous versions of the manuscript. All authors have read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.