MRI Imaging of Uterine Incarceration: From Diagnosis to Posttreatment Follow-Up.

INTRODUCTION

Uterine incarceration is a rare and frequently underrecognized obstetric complication caused by persistent retroversion of the gravid uterus. Because clinical manifestations are often nonspecific, diagnosis may be delayed, increasing the risk of maternal and fetal complications. Imaging, particularly magnetic resonance imaging (MRI), may be essential when ultrasound findings are inconclusive.

CASE PRESENTATION: A 37-year-old multigravida with a history of recurrent pregnancy loss presented at 16 weeks' gestation with acute urinary retention. Clinical examination raised suspicion for uterine incarceration. MRI confirmed the diagnosis by demonstrating a retroverted gravid uterus impacted within the posterior pelvis, associated with elongation and anterior displacement of the cervix and compression of the lower urinary tract. Prompt bladder decompression and successful uterine repositioning were performed, with subsequent resolution of symptoms and favorable maternal-fetal evolution.

DISCUSSION: This case highlights the importance of correlating clinical and imaging findings in pregnant patients presenting with acute urinary symptoms. MRI was decisive in clarifying pelvic anatomy and establishing the diagnosis when sonographic evaluation was limited. Early recognition of uterine incarceration enables timely intervention and may reduce the risk of obstetric and urological complications, contributing to improved maternal-fetal monitoring and management.