Differences between adnexal torsion in pregnant and nonpregnant women

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

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

Tertiary care university hospital.

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

Surgery to treat proved adnexal torsion.

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).

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.