Untwisting and fixation of ovarian torsion in early pregnancy

Abstract EN

Adnexal torsion is a common gynecological emergency with an incidence of around 2-3 %.

Torsion may present as acute or chronic lower abdominal pain, which can be intermittent or constant.

Risks of prolonged torsion include atrophy, necrosis, loss of ovarian function and even premature menopause.2 Traditionally, adnexal torsion has been treated in a radical manner without prior detorsion, due to fear of embolus migration from the twisted pedicle.3 As there is no embolic incident reported in the literature since 1909, ovarian conservation was proposed to avoid castration in young women.4 The concern of miscarriage due to removal of corpus luteum in early pregnancy encourages conservative surgery for ovarian torsion during pregnancy.

We report two cases of ovarian torsion happened in the first trimester of pregnanc which successfully treated by untwisting and fixation of the affected adnexa.