Spontaneous torticollis in a breech-presenting fetus delivered by an atraumatic elective cesarean section: a case and review of the literature.
A non-laboring patient with a breech-presenting fetus and oligohydramnios at 41 weeks' gestation underwent elective cesarean delivery. The infant was delivered atraumatically through a wide transverse incision of the lower uterine segment. Severe leftsided torticollis was noted immediately at delivery. The torticollis subsequently responded to physiotherapy with minimal residual facial asymmetry. This case and the literature suggest that torticollis itself may predispose to breech presentation. Alternatively, in the case presented, oligohydramnios with subsequent restricted posture may have contributed to the underlying pathophysiology of this phenomena, which previously has been noted as associated with and as a possible sequela of traumatic vaginal breech delivery.
Sherer
D M
DM
NICHD, Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC, USA.
D000328:Adult; D000773:Anesthesia, Obstetrical; D001946:Breech Presentation; D002585:Cesarean Section; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016104:Oligohydramnios / Q000150:complications / Q000000981:diagnostic imaging; D026741:Physical Therapy Modalities; D011247:Pregnancy; D014103:Torticollis / Q000209:etiology* / Q000628:therapy; D016216:Ultrasonography, Prenatal