Treatment involves surgery, and though it is not a major one, you will need anaesthesia. Ovarian torsion in second trimester of pregnancy, though is an extremely rare problem in pregnancy, adnexal torsion should be taken into consideration in the differential diagnosis of abdominal pain. ... CPT, MC, USA, is a second-year resident in the Tripler Army Medical Center Department of Obstetrics and Gynecology. A 22-year-old second gravida presented at 22+ weeks gestation with severe abdominal pain and shock. If the fallopian tubes or the ovary gets twisted, it is referred to as ovarian torsion, and this can lead to a lot of pain. The Doppler blood flow signal disappeared in 62.5% of the patients. Most functional cysts resolve by the early second trimester.9,10 In rare cases, a cyst may develop complica-tions such as torsion or rupture, causing acute pain or haemorrhage. Masses that persist into the second trimester are at risk for torsion, rupture, or labor obstruction. Ovarian torsion can be managed conservatively if diagnosed at an earlier gestational age. 1 – 4 While recurrence of HL in subsequent pregnancies has been reported in at least 3 cases, 1 1 8 we had none in our series. Adnexal torsion is frequently associated with ovarian hy-perstimulation therapy or ovarian masses. The blood supply to the ovaries is disrupted, and it causes unbearable pain in pregnant women. Preterm labor. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. The corpus luteum cyst goes away on its own by the second trimester. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women. Ovarian torsion. Adnexal torsion during pregnancy is a rare event and bilateral adnexal torsion is even rarer. Ovarian torsion may occur at any time during pregnancy, although it has been reported to occur more frequently in the first trimester ( 13 , 15 , 16 , 22 , 23 ). It may present with nonspecific signs and symptoms, and should be considered in any female with acute abdominal pain. ... Levy T, Dicker D, Shalev J, et al. The median duration from admission to surgery was 6 hours (range, 1 hour to 3.7 days), being significantly shorter in the first trimester. Even pregnant women can develop ovarian torsion because of the corpus luteum cyst. Hence, ovarian torsion in pregnancy occurs most commonly in the first trimester, occasionally in the second, and rarely in the third. Hum Reprod. Ovarian torsion, therefore, occurs most frequently in the first trimester, occasionally in the second, and rarely in the third. So, ovarian torsion during pregnancy occurs most likely in the first trimester, and rarely in the second and third trimesters. During pregnancy diagnosis of ovarian torsion can be challenging. Hence this case is reported. 8 The safest time to perform laparoscopic surgery in pregnancy is usually the second trimester, and surgery prior to the third trimester has the least risk of premature delivery. 3,4 The fifth most common surgical emergencies are ovarian torsions. [4] Differential diagnosis could be other acute abdominal conditions such as appendicitis, ureteral or renal colic, cholecystitis and bowel obstruction, non preganant horn of bicornuate uterus, appendiceal abscess and ectopic pregnancy. Torsion of a large ovarian dermoid cyst in the second trimester of pregnancy and its management: a case report Author: Goli Kazemi Nia Subject: Background:The Dermoid cyst is the most common ovarian germ cell tumor in pregnant women. Ovarian torsion, also sometimes termed adnexal torsion or tubo-ovarian torsion, refers to rotation of the ovary and portion of the fallopian tube on the supplying vascular pedicle.. The diagnosis is based on an awareness of the relevant risk factors, the clinical presentation, and a high index of suspicion. The cyst usually goes away by the second trimester. Incidence of ovarian surgery required in pregnancy is about 1:1312 pregnancies. Management Cysts less than 6 centimetres in diameter and appearing benign on ultrasound are generally treated conservatively as they may undergo spontaneous resolution. Adnexal torsion during pregnancy is a gynecological emergency. Introduction Ovarian torsion refers to the complete or partial rotation of the ovary on its ligamentous supports, which often leads to an impedance of its blood supply [1].Adnexal torsion during pregnancy is very rare and the incidence is reported to be in the range of 0,01-0,05 per hundred [2].It occurs in all three trimesters, but is most common in the first trimester. 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