Silent uterine torsion in pregnancy

Uterine torsion, although rare, can occur during pregnancy, especially in the presence of a uterine myoma. It is important to have a high level of suspicion and timely management to avoid maternal morbidity and perinatal mortality. We discuss a case of a primigravida with chronic hypertension at 31+6 weeks of pregnancy with imminent signs of eclampsia. An emergency caesarean was done. The intraoperative course was uneventful until the baby’s extraction, when it was observed that there was uterine torsion of 180°, and the uterine incision was in fact on the posterior uterine wall. One 6*5cm International Federation of Gynaecology and Obstetrics type 6 fibroid on the right anterolateral wall was noted. Uterine torsion is unpredictable, with diagnosis mostly done intraoperatively. Although torsion was an incidental finding in our case, it can be associated with maternal and fetal complications if not managed on time.