Differences between adnexal torsion in pregnant and nonpregnant women.
OBJECTIVE
To compare the clinical manifestation, management, and outcome of adnexal torsion in pregnant and nonpregnant women.


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


METHODS
Tertiary care university hospital.


METHODS
Sixty-four pregnant women and 198 nonpregnant women with episodes of adnexal torsion.


METHODS
Surgery to treat proved adnexal torsion.


RESULTS
The mean (SD) gestational age in the pregnant group was 11.5 (7.7) weeks. Thirty six episodes of adnexal torsion in the pregnant group (56%) developed after treatment for infertility, compared with only 14 such episodes (7%) in the nonpregnant group (p < .001). A repeated episode of torsion occurred more frequently in the pregnant group (14% vs 4%; p = .03). Sonographic demonstration of multicystic ovaries was more common in pregnant women with recurrent torsion than in women with a single episode of torsion (86% vs 31%; p = .009). Tissue preservation was achieved more frequently in pregnant than in nonpregnant patients (95% vs 77%; p < .001), and the duration of surgery was 15 minutes shorter in the pregnant women (p < .001).


CONCLUSIONS
Pregnancy after treatment for infertility is a risk factor for adnexal torsion. Recurrence of ovarian torsion occurs more frequently in pregnant patients, and in particular in enlarged multicystic ovaries.
Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel. ginath@gmail.com
Shimon
S
Ginath
Amir
A
Shalev
Ran
R
Keidar
Ram
R
Kerner
Alexander
A
Condrea
Abraham
A
Golan
Ron
R
Sagiv
D000291:Adnexal Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D061646:Operative Time; D059351:Organ Sparing Treatments; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D010062:Ovulation Induction; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014102:Torsion Abnormality / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D014463:Ultrasonography; D055815:Young Adult