{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:25:43Z","timestamp":1771511143560,"version":"3.50.1"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,4,1]]},"abstract":"<jats:p>Uterine torsion is a rare obstetric complication with a non-specific presentation. We describe a patient with a bicornuate uterus and a pregnancy complicated by a markedly elevated second-trimester maternal serum alpha-fetoprotein (MSAFP), intermittent pelvic pain and fetal growth restriction. At 24 weeks gestational age, she presented to labour and delivery with an acute abdomen. A subsequent exploratory laparotomy revealed torsion and rupture of her right uterine horn. Uterine torsion can be difficult to diagnose because it is not associated with specific symptoms or characteristic imaging findings. In patients with a bicornuate uterus who present with abdominal pain, an elevated mid-trimester MSAFP may be a harbinger of placental ischaemia as a result of uterine torsion.<\/jats:p>","DOI":"10.1136\/bcr-2018-224388","type":"journal-article","created":{"date-parts":[[2018,5,26]],"date-time":"2018-05-26T08:29:26Z","timestamp":1527323366000},"page":"bcr-2018-224388","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Uterine torsion and subsequent rupture in a gravid bicornuate uterus associated with an elevated alpha-fetoprotein"],"prefix":"10.1136","volume":"2018","author":[{"given":"Jennah","family":"LaHood","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Whitney","family":"You","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,5,26]]},"reference":[{"key":"2025082803090317000_2018.may25_1.bcr-2018-224388.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-195606000-00001"},{"key":"2025082803090317000_2018.may25_1.bcr-2018-224388.2","first-page":"208","article-title":"Mid-trimester maternal serum AFP levels in predicting adverse pregnancy outcome","volume":"35","author":"Gkogkos","year":"2008","journal-title":"Clin Exp Obstet Gynecol"},{"key":"2025082803090317000_2018.may25_1.bcr-2018-224388.3","first-page":"127","article-title":"Obstetric outcomes in women with mullerian duct malformations","volume":"3","author":"Ramalingappa","year":"2016","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"2025082803090317000_2018.may25_1.bcr-2018-224388.4","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.18203\/2320-1770.ijrcog20162141","article-title":"Torsion of gravid horn of bicornuate uterus: a rare case report","volume":"5","author":"Chundawat","year":"2016","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"2025082803090317000_2018.may25_1.bcr-2018-224388.5","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/j.1471-0528.2002.01060.x","article-title":"Uterine torsion and ischaemia of one horn of a bicornute uterus: a rare cause of failed second trimester termination of pregnancy","volume":"109","author":"Ol\u00e1h","year":"2002","journal-title":"BJOG"},{"key":"2025082803090317000_2018.may25_1.bcr-2018-224388.6","doi-asserted-by":"crossref","first-page":"57","DOI":"10.3126\/njog.v8i2.9773","article-title":"Spontaneous rupture of bicornuate uterus caused by levorotation due to congenital band","volume":"8","author":"Jain","year":"2014","journal-title":"Nepal Journal of Obstetrics and Gynaecology"},{"key":"2025082803090317000_2018.may25_1.bcr-2018-224388.7","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181da93da"},{"key":"2025082803090317000_2018.may25_1.bcr-2018-224388.8","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/S0002-9378(97)70019-X","article-title":"Elevated maternal serum midtrimester alpha-fetoprotein levels are associated with fetoplacental ischemia","volume":"177","author":"Spong","year":"1997","journal-title":"Am J Obstet Gynecol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-224388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:09:13Z","timestamp":1756375753000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-224388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,26]]},"references-count":8,"alternative-id":["10.1136\/bcr-2018-224388"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-224388","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,26]]}}}