Key result
Bilateral adnexal torsion in the third trimester of a twin pregnancy was successfully managed with cesarean section and bilateral adnexectomy, leading to the recovery of the mother and both neonates.
Why the study?
Adnexal torsion is difficult to diagnose during pregnancy, particularly in the third trimester, and bilateral torsion in this setting had not been previously reported.
Case Report (n=1)
No
This is the first reported case of bilateral adnexal torsion in the third trimester of pregnancy, highlighting the need to consider it in the differential diagnosis of acute abdomen in pregnant women.
Alerts clinicians to consider bilateral adnexal torsion in third-trimester acute abdomen; first case leaves management options open for validation.
ntroduction: Torsion is the turning of the adnexa around its axis. It accounts for 3% of all gynecological emergencies. It also happens during pregnancy, as much as 20-25% of all torsions. It most often occurs in pathologically altered ovaries, 60-80% of cases. Causes in pregnancy are more often benign than in nonpregnant women. The diagnosis is established by clinical picture, physical and ultrasound examination. Due to the specificity of pregnancy, it is more difficult to diagnose, especially in the third trimester. Torsion is treated surgically by laparoscopy or laparotomy. Options are detorquation or removal of the necrotic adnexa. Case report: We report the first case of bilateral adnexal torsion in the third trimester of pregnancy. A 32-year-old pregnant woman came to our institution in the 28th week of a spontaneous twin pregnancy with pain in the right hemiabdomen and an episode of vomiting. After clinical, laboratory and ultrasound evaluation, as well as artificial maturation of fetal lungs, cesarean section and bilateral adnexectomy were successfully performed. Pathohistological findings showed infarction and necrosis of the adnexa. Conclusion: Torsion of the adnexa is not uncommon in pregnancy, with 20-25% of all torsions occurring in pregnant women. Torsion of the adnexa should be considered in the differential diagnosis of pain in pregnancy, especially if it is accompanied by nausea, vomiting and fever.
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Miloš Milinčić (2023) conducted a case report in Bilateral adnexal torsion in pregnancy (n=1). Cesarean section and bilateral adnexectomy was evaluated on Clinical recovery and fetal delivery. Bilateral adnexal torsion in the third trimester of a twin pregnancy was successfully managed with cesarean section and bilateral adnexectomy, leading to the recovery of the mother and both neonates.
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