Association between pregnancy and adnexal torsion

Abstract

The purpose of this study was to determine the effect of pregnancy on adnexal torsion (AT). We conducted a matched case-control study using the Korean Health Insurance Review and Assessment Service–National Inpatients Sample (HIRA-NIS) from 2009 to 2011. AT patients were defined as women with both a diagnostic code (N835) and a surgical code for AT. The AT patients were randomly matched 1:4 with women without AT by age and year of claim. In total, 545 AT cases and 2180 controls were enrolled from a total of 1,843,451 women. After adjustment for such covariates as age, pregnancy was found to be associated with a lower rate of AT (adjusted odds ratio 0.314, 95% confidence interval [CI] 0.237–0.416, P value <0.01) and ovarian hyperstimulation syndrome was associated with a higher rate of AT (adjusted odds ratio 20.091, 95% CI 3.607–111.908, P value <0.01). We found that pregnancy is a negative risk factor for AT. However, a further study is needed to elucidate the mechanisms underlying these results.

Laparoscopic detorsion of the ovary in ovarian hyperstimulation syndrome during the sixth week of gestation: A case report and review

“…Ovarian torsion is an acute condition, and a delay in treatment increases the risk of functional loss of the ovary and early termination of the pregnancy; therefore, prompt diagnosis and surgical treatment are essential. Classical risk factors for ovarian torsion such as a large tumor, pregnancy, and ovarian hyperstimulation for the treatment of infertility are well known [2]. The symptoms of ovarian torsion are usually nonspecific; however, acute abdominal pain occurs in many cases, often starting suddenly and persisting for more than 24 h. Ultrasonography is the most safe and useful imaging modality for a prompt and accurate diagnosis in pregnant females with acute abdominal pain due to its wide availability and absence of radiation.…”

“…Ovarian torsion is a relatively common gynecological emergency and is the fifth most common gynecological surgical emergency [1,2]. While a diagnosis of ovarian torsion is likely to be missed due to its nonspecific symptoms, prompt surgical intervention is needed to preserve ovarian function and fertility.…”

Adnexal Torsion in the Third Trimester

“…It is estimated that 12-18% of all cases of AT occur during pregnancy [ 3 ], with only 19% of these occurring in the third trimester [ 2 ]. Whether pregnancy itself represents a risk factor for AT is contentious, with some evidence that pregnancy may even be protective [ 2 , 4 , 5 ]. When AT does occur in pregnancy, being in the first trimester or early second trimester [ 2 , 6 , 7 ], ovarian hyperstimulation secondary to assisted reproductive technology [ 2 , 8 ], and the presence of pre-existing ovarian masses greater than 5 cm in diameter [ 4 , 7 ] are thought to be the most significant risk factors.…”