Asymptomatic axial torsion of the pregnant uterus: a cause of the failure of induction of mid-trimester abortion.

Torsion of gravid uterus is a rare obstetric condition in which diagnosis is usually made only on laparotomy. A case of asymptomatic axial torsion of uterus during mid-trimester, because of an ovarian cyst is reported. This presented as a failure of induction of abortion by extra-amniotic isotonic saline instillation and oxytocin infusion.

Evaluation and two-year follow-up of 455 infertile couples--pregnancy rate and outcome.

A total of 455 infertile couples were evaluated in our infertility clinic over a period of 2 years and were followed up for 2 years for occurrence of pregnancy. Couples were thoroughly investigated to determine the etiological factor in the male and female partners. One hundred and seventy-five women (38.5%) became pregnant, 47 (28%) before the complete evaluation, 66 (38%) after total work-up, and 62 (35%) after successful treatment. When both partners were normal, 40% of the woman became pregnant, but only 24% when a defect was detected in both. Half the women in the age group less than 25 years conceived compared to only one-fourth when age was more than 35 years. Sixty-five percent became pregnant when the duration of infertility was less than 2 years, and only 20% when duration was more than 4 years. One hundred and thirty (84.4%) had successful outcome of pregnancy, of which 58% had normal vaginal delivery. Spontaneous abortion occurred in 13% of cases; only one patient had an ectopic pregnancy. Cesarean section rate was 27%, and 11.8% were delivered by low midcavity forceps.