title: Pregnancy outcome after unwinding of twisted ischaemic-haemorrhagic adnexa.
abstract: Six women who became pregnant after human menopausal gonadotrophin/human chorionic gonadotrophin (hMG/hCG) treatment regimens were operated on between 6 and 21 weeks gestation with an intra-operative diagnosis of twisted ischaemic-haemorrhagic adnexa. During operation unwinding of the adnexa was performed in all patients. Monitoring of the pregnancy before and after operation by ultrasonography was normal. The postoperative period and the rest of the pregnancy were uneventful. Three women were delivered normally at term. One patient was delivered by caesarean section because of twin pregnancy with malpresentation, and two pregnancies are still ongoing beyond the first trimester. This preliminary study suggests that detorsion of ischaemic-haemorrhagic adnexa during pregnancy is an option that is not associated with subsequent complications. This approach might be adopted relatively safely when preservation of future fertility is a goal.
authors.affiliation: Department of Obstetrics and Gynecology, Chain Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Bider
authors.forename: Z
authors.initials: Z
authors.lastname: Ben-Rafael
authors.forename: M
authors.initials: M
authors.lastname: Goldenberg
authors.forename: J
authors.initials: J
authors.lastname: Shalev
authors.forename: S
authors.initials: S
authors.lastname: Mashiach
mesh_terms: D000290:Adnexa Uteri / Q000098:blood supply*; D000291:Adnexal Diseases / Q000601:surgery*; D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006470:Hemorrhage; D006801:Humans; D007231:Infant, Newborn; D007511:Ischemia / Q000601:surgery*; D007902:Length of Stay; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery; D011256:Pregnancy Outcome; D014102:Torsion Abnormality