P17.12: Three cases of cervical distortion secondary to incarceration of a retroverted gravid uterus: ultrasound features and management challenges
Bibliographic record
Abstract
Case 1: Presented with urinary retention and evidence of gross cervical stretching in the mid-trimester. The incarceration was not actively treated and the pregnancy miscarried at 19 weeks. In her second pregnancy, an elective cerclage at 12 weeks was challenging due to recurrent incarceration and an external os flush with the vaginal wall. The cervix only became recognizable after intraoperative uterine anteversion. Due to the short intravaginal segment of the cervix, a Shirodkar-type cerclage was required. Delivery was at term. In the current pregnancy, the uterus was manually anteverted in the ultrasound department at 11 weeks. Serial cervical ultrasound surveillance was offered but she preferred elective cerclage. A normal intravaginal cervical segment was present and a MacDonald suture was placed at 12 weeks with no difficulty. She is currently 28 weeks in an uncomplicated pregnancy with normal cervical ultrasounds. Case 2: Presented at 17 weeks with urinary retention, constipation and pelvic pain. The uterus was found incarcerated with an inability to visualise the cervix. Anteversion could only be achieved under spinal anesthesia. A pessary was initially used to maintain anteversion. Currently 32 weeks, she has remained asymptomatic and anteverted. Case 3: Referred at 21 weeks, when the anterior cervix was found to be grossly stretched in front of a retroverted uterine body. Manual anteversion was not possible. A Caesarean section at 34 weeks, a very high anterior transverse uterine incision was made, just below the apical curvature that led to the retroverted uterine body. After delivery, with the uterus normally orientated, the Caesarean section incision was in the anatomical lower uterine segment with the cervical internal os just below it. At 3 months postpartum, ultrasound showed an acutely retroflexed uterus and confirmed the incision was just above the cervix.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".