Maternal adnexal torsion in pregnancy is associated with significant risk of recurrence.
OBJECTIVE
To investigate the phenomenon of recurrent adnexal torsion during the same pregnancy, describe its risk factors, and suggest possible management of this entity.


METHODS
Retrospective case-control study (Canadian Task Force classification II-3).


METHODS
Gynecologic endoscopy unit in a university hospital.


METHODS
Pregnant women with surgically proved adnexal torsion were retrospectively identified from 1993 to 2007. Details of clinical presentation, method of conception, preoperative ultrasound findings, and operative findings were analyzed.


METHODS
Comparison of characteristics of patients with recurrent episodes of adnexal torsion during the same pregnancy vs a single episode of torsion.


RESULTS
Thirty-three pregnant women with 38 episodes of adnexal torsion were included in the study. Seventeen pregnancies (51.5%) were spontaneously conceived. Twenty-eight women had a single episode of torsion, and 5 women (15.1%) had recurrent episodes of torsion during the same pregnancy. No significant differences were found between the 2 groups in age, method of conception, and gestational age at time of torsion. However, ultrasound studies demonstrated that multicystic ovaries were significantly more common in women with recurrent torsion compared with women with a single episode of torsion (80% vs 25%; p =.02). The interval between the first and second episodes of torsion ranged from 1 to 4 weeks.


CONCLUSIONS
Pregnant women are at risk for recurrent torsion, especially when the ovaries are enlarged and ultrasound studies demonstrate multiple cysts. Cyst aspiration may prevent recurrent torsion during the same pregnancy.
Pansky
Moty
M
Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel. MotyP@asaf.health.gov.il
Feingold
Michal
M
Maymon
Ron
R
Ben Ami
Ido
I
Halperin
Reuvit
R
Smorgick
Noam
N
D000291:Adnexal Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D010048:Ovarian Cysts / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012008:Recurrence; D012307:Risk Factors; D014102:Torsion Abnormality / Q000453:epidemiology*