The Clinical Characteristics and Sonographic Findings of Maternal Ovarian Torsion in Pregnancy

Smorgick, Noam; Pansky, Moty; Feingold, Mordechai; Herman, Arie; Halperin, Reuvit; Maymon, Ron

doi:10.1097/ogx.0b013e3181e39aae

Cited by 22 publications

(43 citation statements)

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“…This situation can be associated with increased ligament laxity in childhood and pregnancy [1,16]. On the other hand, ultrasonography may fail in the early stages of ovarian torsion [1,3].…”

Section: Discussionmentioning

confidence: 97%

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Diagnostic performance of diffusion-weighted MRI in the diagnosis of ovarian torsion: comparison of torsed and nonaffected ovaries

et al. 2016

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Section: Discussionmentioning

confidence: 97%

“…The increased incidence of ovarian torsion in children and pregnant women has attracted attention [15][16][17]. This situation can be associated with increased ligament laxity in childhood and pregnancy [1,16].…”

Section: Discussionmentioning

confidence: 98%

Diagnostic performance of diffusion-weighted MRI in the diagnosis of ovarian torsion: comparison of torsed and nonaffected ovaries

et al. 2016

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“…The first signs and symptoms of torsion develop when decreased venous and lymphatic return increases the size of the ovary; eventually arterial supply to the ovary is restricted as well, leading to ischemia and necrosis if left untreated (1,5,6). The right ovary is 50% more likely to twist and cause torsion than the left, implying that the sigmoid colon may protect against torsion (7,9). It is crucial to identify torsion early to preserve the ovary.…”

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confidence: 96%

“…The ovary appears unilaterally enlarged with edema and multiple cystic structures that often are accompanied by some degree of ascites (3,7). Although it is possible to use Doppler flow to diagnose torsion, it has been shown that Doppler may miss up to 60% of cases as there is often no change in vascular flow (2)(3)(4).…”

mentioning

confidence: 98%

“…Torsion can be a severe complication after ovarian stimulation, and it frequently may accompany ovarian hyperstimulation syndrome (OHSS) (2)(3)(4)6). As symptoms are mainly nonspecific, ovarian torsion often may be confused with other conditions including a ruptured corpus luteum cyst, adnexal abscess, ovarian hyperstimulation, urinary obstruction, heterotopic pregnancy, and appendicitis (2,6,7).…”

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confidence: 99%

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Recurrence of ovarian torsion in a multiple pregnancy: conservative management via transabdominal ultrasound–guided ovarian cyst aspiration

Boswell¹,

Silverberg

2010

Fertility and Sterility

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Comparison of subsequent pregnancy outcomes after surgery for adnexal masses performed in the first and second trimester of pregnancy

Zou

Zhu

et al. 2019

Intl J Gynecology & Obste

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Objective:To determine whether surgery for adnexal masses in the first trimester of pregnancy affects subsequent pregnancy outcomes compared to surgery in the second trimester.Methods: Data were retrospectively reviewed from women who underwent adnexal mass surgery before 26 weeks of gestation at a university hospital between July 2008 and June 2018. Women who underwent surgery in the first trimester were classified as group 1 (n=78) and those in the second trimester were classified as group 2 (n=48).Information on clinical characteristics and pregnancy outcomes was obtained from medical records and follow-up interviews and compared between two groups.Results: There were no differences in age, parity, mass size, laparoscopy, and operation time between the two groups. A total of 98 cases were confirmed as ovarian torsion, including 72 cases in group 1 and 26 cases in group 2. Accordingly, adnexectomy was performed more often in group 1 (P=0.002). No significant differences concerning the rate of abortion, preterm birth, or cesarean delivery were found.Conclusion: Surgery for adnexal masses performed in the first trimester is almost as safe as that in the second trimester. Surgery should be performed for women with a complex adnexal mass in the first trimester to avoid unfavorable complications. K E Y W O R D SAdnexal masses; Adnexal torsion; First trimester; Pregnancy outcomes; Second trimester; Surgery During the study period, a total of 160 women underwent surgery for adnexal masses before 26 weeks of gestation (Fig. 1). Among them, six women did not want to continue the pregnancy and received aspiration and curettage. For two women, the pregnancy was terminated by intraamniotic injection of ethacridine lactate because of fetal malformation (one for Down syndrome and the other for serious hydronephrosis of the fetus). The remaining 152 women continued the pregnancy, including 26 women lost to follow-up. Finally, 126 (82.9%) women met the inclusion criteria. In total, 78 cases were included in group 1 and 48 cases were included in group 2. The median age of gestation at the time of surgery was 9 weeks in group 1 and 15 5/7 weeks in group 2.Data showing the patients' characteristics are shown in Table 1.There was no difference in terms of maternal age, parity, or adnexal mass size between the two groups. Significantly more emergency surgeries were performed in group 1 compared with group 2 (75 [96.2%] vs 29 [60.4%], P<0.001). There were more twin pregnancies and more patients conceived through assisted reproductive technologies (ART) in group 1 (P=0.008 and P=0.007, respectively).The characteristics of the surgical procedure are shown in Table 2.There were no significant differences between the two groups regarding use of laparoscopy or operation time. However, surgical indications were significantly different. Suspected ovarian torsion occurred significantly more frequently in cases in group 1 (75 [96.2%], P<0.001), while a persistent mass was more frequent in group 2 (19 [39.6%], P<0.001). A total of 98 cases we...

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The Clinical Characteristics and Sonographic Findings of Maternal Ovarian Torsion in Pregnancy

Cited by 22 publications

References 0 publications

Diagnostic performance of diffusion-weighted MRI in the diagnosis of ovarian torsion: comparison of torsed and nonaffected ovaries

Diagnostic performance of diffusion-weighted MRI in the diagnosis of ovarian torsion: comparison of torsed and nonaffected ovaries

Recurrence of ovarian torsion in a multiple pregnancy: conservative management via transabdominal ultrasound–guided ovarian cyst aspiration

Comparison of subsequent pregnancy outcomes after surgery for adnexal masses performed in the first and second trimester of pregnancy

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