Differences Between Adnexal Torsion in Pregnant and Nonpregnant Women

Study Objective: To compare the clinical manifestation, management, and outcome of adnexal torsion in pregnant and nonpregnant women. Design: Retrospective case-control study (Canadian Task Force classification II-3). Setting: Tertiary care university hospital. Patients: Sixty-four pregnant women and 198 nonpregnant women with episodes of adnexal torsion. Interventions: Surgery to treat proved adnexal torsion. Measurements and Main Results: 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). Conclusion: 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.