1887
Volume 2023, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

The ovary’s Torsion is the adnexa’s total or partial rotation around its vascular axis or pedicle. Complete torsion causes venous and lymphatic blockade leading to stasis, venous congestion, hemorrhage, and necrosis. If neglected, it may result in permanent loss of the affected ovary. Ovarian torsion is one of the most critical gynecological surgical emergencies. Therefore, it requires urgent surgical intervention. It is mainly diagnosed by clinical examination and ultrasound. Ovarian torsion is primarily seen in the first trimester of pregnancy.1,2 Infertility treatment is a significant risk factor due to ovarian stimulation. We present a case of acute abdominal pain who came to the emergency department of Al Ahli Hospital, diagnosed as right adnexal torsion with viable intrauterine pregnancy at six weeks. Laparoscopic oophorectomy was done by removing the corpus luteum cyst, which supports early pregnancy. Despite its disposal, the pregnancy continued because the hormonal therapy started in doses higher than recommended for threatened abortion.3 Eventually, she gave birth to a healthy baby boy at 35 weeks.

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2023-09-07
2024-06-02
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References

  1. Feng J-L, Zheng J, Lei T, Xu Y-J, Pang H, Xie H-N. Comparison of ovarian torsion between pregnant and non-pregnant women at reproductive ages: Sonographic and pathologic findings. Quant Imaging Med Surg. 2020; 10:(1):137–47.
    [Google Scholar]
  2. Young R, Cork K. Intermittent ovarian torsion in pregnancy. Clin Pract Cases Emerg Med. 2017; 1:(2):108–10. doi:10.5811/cpcem.2016.12.32932.
    [Google Scholar]
  3. Duncan WC. The inadequate corpus luteum. Reprod Fertil. 2021; 2:(1):C1–7.
    [Google Scholar]
  4. Hibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985; 152:(4):456–61.
    [Google Scholar]
  5. Bignardi T, Condous G. The management of ovarian pathology in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2009; 23:(4):539–48.
    [Google Scholar]
  6. Gorkemli H, Camus M, Clasen K. Adnexal torsion after gonadotrophin ovulation induction for IVF or ICSI and its conservative treatment. Arch Gynecol Obstet. 2002; 267:(1):4–6.
    [Google Scholar]
  7. Pride SM, James CSJ, Yuen BH. The ovarian hyperstimulation syndrome. Semin Reprod Endocrinol. 1990; 8::247–60.
    [Google Scholar]
  8. American Society of reproductive medicine . Ovarian hyperstimulation syndrome {OHSS}. Fertil Steril. 2008; 90::S188–93.
    [Google Scholar]
  9. Huchon C, Fauconnier A. Adnexal torsion: A literature review. Eur J Obstet Gynecol Reprod Biol. 2010; 150:(1):8–12.
    [Google Scholar]
  10. Glanc P, Salem S, Farine D. Adnexal masses in the pregnant patient: A diagnostic and management challenge. Ultrasound Q. 2008; 24:(4):225–40.
    [Google Scholar]
  11. Hess LW, Peaceman A, O’Brien WF, Winkle CA, Cruishank DP, Morrison JC. Adnexal mass occurring with intrauterine pregnancy: Report of 54 patients requiring laparotomy for definitive management. Am J Obstet Gynecol. 1988; 158:(5):1029–34.
    [Google Scholar]
  12. Charlie C. Adnexal torsion. Baylor College of Medicine. Mar 2021.
    [Google Scholar]
  13. Shadinger LL, Andreotti RF, Kurian RL. Preoperative sonographic and clinical characteristics as predictors of ovarian torsion. J Ultrasound Med. 2008; 27:(1):7–13
    [Google Scholar]
  14. El-Shawarby SA, Henderson AF, Mossa MA. Ovarian cysts during pregnancy: Dilemmas in diagnosis and management. J Obstet Gynecol. 2005; 25:(7):669–75.
    [Google Scholar]
  15. Shur J, Bottomley C, Walton K, Patel JH. Imaging of acute abdominal pain in the third trimester of pregnancy. BMJ. 2018; 361::K2511.
    [Google Scholar]
  16. Shah D, Nagarajan N. Luteal insufficiency in the first trimester. Indian J Endocrinol Metab. 2013; 17:(1):44–9.
    [Google Scholar]
  17. Chen L, Ding J, Hua K. Comparative analysis of laparoscopy versus laparotomy in managing ovarian cyst during pregnancy. J Obstet Gynecol Res. 2014; 40:(3):763–9.
    [Google Scholar]
  18. Reedy MB, Källén B, Kuehl TJ. Laparoscopy during pregnancy: A study of five fetal outcome parameters using the Swedish Health Registry. Am J Obstet Gynecol. 1997; 177:(3):673–9.
    [Google Scholar]
  19. Candiani M, Maddalena S, Barbieri M, Izzo S, Alberico D, Ronzoni S. Adnexal masses in pregnancy: Fetomaternal blood flow indices during laparoscopic surgery. J Minim Invasive Gynecol. 2012; 19:(4):443–7.
    [Google Scholar]
  20. Csapo AI, Pulkkinen MO, Ruttner B, Sauvage JP, Wiest WG. The significance of the human corpus luteum in pregnancy maintenance. I. Preliminary studies. Am J Obstet Gynecol. 1972; 112:(8):1061–7. doi:10.1016/0002-9378(72)90181-0.
    [Google Scholar]
  21. National Institute for Health and Clinical Excellence . Ectopic pregnancy and miscarriage: Diagnosis and initial management. NICE guideline [NG 126] /2019. https://www.nice.org.uk/guidance/ng126/resources/ectopic-pregnancy-and-miscarriage-diagnosis-and-initial-management-pdf-66141662244037
    [Google Scholar]
  22. Coomarasamy A, Harb HM, Devall AJ, Cheed V, Roberts TE, Goranitis I, et al.. Progesterone to prevent miscarriage in women with early pregnancy bleeding: The PRISM RCT. Health Technol Assess. 2020; 24:(33):1–70.
    [Google Scholar]
  23. Norwitz ER, Caughey AB. Progesterone Supplementation and the Prevention of Preterm Birth. Rev Obstet Gynecol. 2011; 4:(2):60–72.
    [Google Scholar]
  24. Food and Drug Administration (FDA) . Application number: 21945Orig1s000. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/021945Orig1s000Approv.pdf
    [Google Scholar]
  25. National Institute for Health and Clinical Excellence . Preterm labor and birth. NICE guideline [NG 25] /2022. https://www.nice.org.uk/guidance/ng25/resources/preterm-labour-and-birth-pdf-1837333576645
    [Google Scholar]
  26. Deng Y, Chen C, Luo S, Mai G, Liao X, Tian H, et al.. Baseline serum progesterone levels and the first-trimester pregnancy outcome in women with threatened abortion: A retrospective cohort study. Biomed Res Int. 2020; 2020::8780253. doi:10.1155/2020/8780253.
    [Google Scholar]
  27. Siew JYS, Allen JC, Hui CYY, Ku CW, Malhorta R, Østbye T, et al.. The randomized controlled trial of micronized progesterone and dydrogesterone (TRo MaD) for threatened miscarriage. Eur J Obstet Gynecol Reprod Biol. 2018; 228::319–24.
    [Google Scholar]
  28. Royal College of Obstetricians and Gynaecologists (RCOG) . Cervical cerclage: Green top guideline No 75. 2022. https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/cervical-cerclage-green-top-guideline-no-75/
    [Google Scholar]
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  • Article Type: Case Report
Keyword(s): Corpus luteumFirst trimesterOvarian torsion and Progesterone
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