The clinical characteristics and sonographic findings of maternal ovarian torsion in pregnancy.
OBJECTIVE
To investigate the incidence, risk factors, and sonographic findings of maternal ovarian torsion in pregnancy.


METHODS
Retrospective study.


METHODS
Department of Obstetrics/Gynecology of a tertiary referral center.


METHODS
Thirty-three pregnant women with 38 episodes of surgically proven torsion between the years 1993 to 2007.


METHODS
Surgical confirmation and treatment of torsion.


METHODS
Clinical and sonographic findings of ovarian torsion in pregnancy.


RESULTS
Sixteen (48.5%) pregnancies were conceived by ovulation induction or in vitro fertilization. Twenty-one torsion events occurred in the first trimester (55.3%) versus 13 (34.2%) and 4 (10.5%) in the second and third trimester, respectively. All patients were admitted with abdominal pain, whereas 22 (57.9%) reported nausea/vomiting. The preoperative ultrasound examination showed unilocular ovarian cysts in 15 (39.5%) cases, multicystic ovaries in 14 (36.8%), and normally appearing ovaries in 9 (23.7%) cases. The multicystic ovary was more common in the first trimester torsion, whereas the "normal" appearing ovary was more common in the second and third trimester torsion (47.6% vs. 23.5% and 14.3% vs. 35.3%, respectively). The median duration from admission to surgery was 6 hours (range, 1 hour to 3.7 days), being significantly shorter in the first trimester.


CONCLUSIONS
Ovarian torsion in pregnancy is more common in the first trimester, and induction of ovulation is a major risk factor.
Smorgick
Noam
N
Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel. noam_yossi@yahoo.com
Pansky
Moty
M
Feingold
Michal
M
Herman
Arie
A
Halperin
Reuvit
R
Maymon
Ron
R
D000328:Adult; D016208:Databases, Factual; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015994:Incidence; D010048:Ovarian Cysts / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012307:Risk Factors; D054159:Torsion, Mechanical; D014463:Ultrasonography; D055815:Young Adult