Pregnancy and a Tipped Uterus
Introduction
Approximately 11-19 % of pregnant women have a tipped uterus during the first trimester. It is generally not a cause for concern in the majority of women, as the retroversion corrects itself, and the pregnancy proceeds with the uterus in an anteverted or forward facing position. However, in rare instances - .03% (1 In 3000) to 1.4% (42 in 3000) depending on the study consulted - the uterus does not right itself. The uterus can become trapped or incarcerated in the pelvic area as it continues to enlarge instead of moving upwards into the abdomen. Uterine incarceration is a serious complication of pregnancy that can result in miscarriage, pre-term labor and other consequences that can endanger the life of the mother and/or fetus. If recognized early, the position of the uterus can be corrected, and the pregnancy can proceed normally.
Because of potential problems, if you have a retroverted uterus and are pregnant or thinking of becoming pregnant, you may wish to read this information and/or bring it to the attention of your physician during the course of your pre-natal healthcare. He or she may then monitor the position of your uterus during the course of pregnancy as a preventative measure.
What is an Incarcerated Uterus ?
An incarcerated uterus does not ascend into the abdominal cavity. Instead, it becomes wedged in the pelvic cavity between the sacrum and the pubis. The increased pressure displaces the cervix and compromises function of the bladder, kidneys and the colon among other organs.
Symptoms
Patients with incarceration usually though not always experience the following symptoms between 12 and 20 weeks of their pregnancy:
- Frequent need to urinate
- Sense of incomplete bladder emptying
- Urinary retention
- Constipation
- Lower abdominal pain
- Vaginal bleeding
Sometimes a woman with an incarcerated uterus will remain asymptomatic until the third trimester or even until labor begins at term.
If an incarcerated uterus is suspected, a manual exam and ultrasound are used to confirm the diagnosis.
Consequences of an Incarcerated Uterus ?
Patients with an untreated incarcerated uterus may experience hemorrhage and spontaneous abortion. Fetal loss of up to 33% has been reported in women with uterine incarceration. The earlier the incarceration is detected, the more favorable the prognosis for the fetus.
Less commonly reported complications include intrauterine infection, rectal gangrene and rupture of the bladder or uterus.
What You Can Do
If you have a tipped 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 tipped 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.
