Successful pregnancy complicated by early and late adnexal torsion after in vitro fertilization

Rackow, Beth W.; Patrizio, Pasquale

doi:10.1016/j.fertnstert.2006.05.091

Cited by 73 publications

(65 citation statements)

References 22 publications

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“…[4][5][6][7][8] Many anatomic and physiologic factors predispose a woman to experience torsion of the ovary, but the true etiology is not always identified. Pregnant women who conceive as a result of controlled ovarian stimulation are at greater risk for the development of ovarian torsion 5,6 as seen in our case series. With an increasing number of women undergoing assisted reproductive technology with controlled ovarian stimulation, it is essential for physicians to suspect ovarian torsion when confronted with a patient presenting with acute onset abdominal pain, nausea, and/or vomiting.…”

Section: Discussionmentioning

confidence: 99%

“…This implies that full arterial constriction does not often occur; rather the edema and venous stasis may cause the mottled appearance of the affected ovary. 4,6 The imaging study of choice to diagnose ovarian torsion is Doppler ultrasound, as it may show absent or reduced blood flow to the ovary. 8 The ovary appears unilaterally enlarged with edema and multiple cystic structures that often are accompanied by some degree of ascites.…”

Section: Discussionmentioning

confidence: 99%

“…8 The ovary appears unilaterally enlarged with edema and multiple cystic structures that often are accompanied by some degree of ascites. 6,9 Although it is possible to use Doppler flow to diagnose torsion, it has been shown that Doppler may miss up to 60% of cases as there is often no change in vascular flow. [5][6][7] In such cases, a strong clinical suspicion of ovarian torsion must lead to laparoscopic evaluation.…”

Section: Discussionmentioning

confidence: 99%

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Ovarian Torsion: A Gynecological Emergency

Garg¹,

Krishna²,

Rathor³

2015

International Journal of Infertility &Amp; Fetal Medicine

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Ovarian torsion is an uncommon gynecological emergency that requires prompt recognition and treatment. Timely investigation and management can make the difference between ovarian loss and salvage, an outcome of great importance in the population of reproductive age females. Our case series is about clinical presentation and management approach of adnexal torsion in a tertiary care fertility center. Adnexal torsion was found mainly in the reproductive age during poststimulation postovulatory period in all cases. Ultrasound was the most commonly used imaging modality. Ovarian stimulation was the risk factor seen in all the patients. Diagnosis of adnexal torsion was mostly clinical. Laparoscopy was the preferred method of surgical intervention. Ovarian conservation was possible in all cases except one.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ovarian Torsion: A Gynecological Emergency

Garg¹,

Krishna²,

Rathor³

2015

International Journal of Infertility &Amp; Fetal Medicine

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“…10 Adnexal torsion in these cases may occur at any time during gestation, although its incidence decreases as the gestational age increases. [12][13][14] In contrast, torsion of the normal adnexa during pregnancy or the postpartum period is uncommon, and the true incidence of such a rare condition is unclear. According to the previously reported literature, torsion of a normal ovary predominantly occurs in premenarchal female patients, in whom torsion involving previously normal adnexa may constitute up to 15% to 50% of adnexal torsion cases.…”

Section: Torsion Of a Normalmentioning

confidence: 99%

Torsion of a Normal Ovary During the Early Postpartum Period

Tanaka

Koyama

Shiki

2015

CRSLS

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Ovarian cyst torsion is a well-known cause of acute abdominal pain in female patients. However, torsion of a normal ovary is extremely rare and predominantly occurs in premenarchal female patients. The objective of this report is to describe a rare case of acute abdomen during the early postpartum period that was ultimately diagnosed as torsion of a normal ovary by laparoscopic surgery. A 29-year-old woman vaginally delivered a healthy 3530-g baby uneventfully at 40 weeks' gestation. On postpartum day 6, she presented with acute abdominal pain in the right lower quadrant and costovertebral angle tenderness. A complete workup including laboratory examination, ultrasonography, and computed tomography was performed. Leukocytosis with a left shift and a slightly enlarged right ovary were found. Finally, diagnostic laparoscopy showed torsion of a normal ovary. The patient underwent laparoscopic detorsion of the right adnexa and was discharged on postoperative day 4 without any complications.

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“…Adnexal torsion can occur at any age. It is estimated that 70-80 % of adnexal torsions occur in women of reproductive age, and 12-25 % of women with torsion are pregnant [21]. It is commonly associated with an increase of the ovarian size and weight.…”

Section: Adnexal Torsionmentioning

confidence: 99%

Diagnosis of emergencies/urgencies in gynecology and during the first trimester of pregnancy

Zucchini¹,

Marra²

2014

J Ultrasound

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Several surgical and/or medical emergencies/ urgencies may occur in gynecologic patients and in pregnant women during the first trimester. Particularly, ectopic pregnancies, ruptured or hemorrhagic ovarian cysts, ovarian or adnexal torsions, threatened or inevitable miscarriages, phlogistic gynecological disorders, complications involving the uterine fibroids, endometriosis, and spontaneous uterine rupture are possible acute complications. The diagnosis is suspected on the basis of symptoms (acute pelvic and/or abdominal pain, with or without vaginal bleeding or discharge, until acute abdomen with peritonitis), by means physical evaluation (abdominal, pelvic, and bimanual gynecological examinations), by means of transabdominal (TAS) and/or transvaginal (TVS) sonography, and laboratory tests. However, the diagnosis is often not that simple, especially when the symptoms and clinical signs are minimal, and ultrasound (US) examination is not diriment. The differential diagnosis of abdominal/pelvic pain is broad and includes primarily gastrointestinal and urogenital disorders. Generally, TAS should usually be used in conjunction with TVS for evaluation of the female pelvis. If the US examination is not conclusive, CT or MRI, especially in pregnant patients, should be considered.Riassunto Diverse emergenze/urgenze chirurgiche e/o mediche possono interessare le pazienti ginecologiche e le gravide al primo trimestre. In particolare, le gravidanze ectopiche, le cisti ovariche rotte o torte, le torsioni ovariche o annessiali, le minacce d'aborto o gli aborti inevitabili, le patologie infiammatorie ginecologiche, i fibromi uterini complicati, l'endometriosi e la rottura uterina spontanea rappresentano possibili complicanze acute. La diagnosi può essere sospettata in base alla sintomatologia (algie pelviche e/o addominali acute, con eventuali perdite vaginali, fino a un quadro di addome acuto con peritonite), alla visita (valutazione addominale, pelvica ed esplorazione ginecologica bimanuale), all'ecografia transaddominale (TAS) e/o transvaginale (TVS), e agli esami di laboratorio. Tuttavia, la diagnosi spesso non è semplice, soprattutto quando i sintomi e i segni clinici sono lievi e l'ecografia non è dirimente. La diagnosi differenziale del dolore addominale/ pelvico comprende un'ampia varietà di disordini, in particolare gastrointestinali e urogenitali. Generalmente, la valutazione della pelvi femminile dovrebbe essere eseguita mediante ecografia sia transaddominale che transvaginale. Se l'esame ecografico non consente di fare diagnosi, dovrebbero essere presi in considerazione la TC o, specialmente nelle donne gravide, la RMI.

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Successful pregnancy complicated by early and late adnexal torsion after in vitro fertilization

Cited by 73 publications

References 22 publications

Ovarian Torsion: A Gynecological Emergency

Ovarian Torsion: A Gynecological Emergency

Torsion of a Normal Ovary During the Early Postpartum Period

Diagnosis of emergencies/urgencies in gynecology and during the first trimester of pregnancy

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