Management of an Incarcerated Uterus

Management

A standardized protocol for treating an incarcerated uterus does not exist.  Management techniques depend on the age of the fetus when the condition is recognized.

Management 14 to 20 Weeks Gestation

If the incarceration is diagnosed from 14 to 20 weeks gestation, a number of techniques can be used to reposition the uterus into the abdominal cavity. After the uterus has been repositioned, a pessary is may be placed in the vagina to help support the uterus in its proper position. Bed rest may also be prescribed. 

Management Beyond 20 Weeks Gestation

If the incarceration is diagnosed after 20 weeks, the patient is usually monitored closely for signs and symptoms of premature labor. Delivery is usually by caesarian section.    

Risk Factors for Uterine Incarceration

A woman with a retroverted uterus that failed to reposition itself, is at risk of developing an incarcerated uterus in subsequent pregnancies.

In addition to a retroverted uterus, factors that can contribute to an incarcerated uterus include:

• Pelvic inflammatory disease
• Endometriosis
• Post-operative adhesions
• Fibroids

Prevention 

Preventive measures include:

• Uterine suspension such as the UPLIFT procedure to reposition a retroverted uterus to a forward position
• Knee-chest exercises
• Pelvic exam to monitor uterine position at 14 weeks
• Placement of a vaginal pessary

What You Can Do

If you have a retroverted uterus and are experiencing symptoms discussed in this section, talk to your doctor as soon as possible. Early recognition is key to a successful outcome.  Additionally, it is important to mention that you have a retroverted uterus should you require urgent or emergency care. The information may be helpful in establishing a diagnosis and ensuring you receive the most appropriate treatment.