Early diagnosis and treatment are es-sential to save the adnexa and decrease maternal and fetal morbidity [8]. 3,4 The fifth most common surgical emergencies are ovarian torsions. An ovarian mass that iş 6 cm in diameter or symptomatic is usually considered signiWcant and requires surgical intervention. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). It is an unusual complication of pregnancy and for most obstetricians it probably represents a ‘once-in-a-lifetime’ diagnosis. The symptoms are nonspecific, and can be confused with other acute abdominal conditions such as appendicitis, ureteral or renal colic, cholecystitis and bowel obstruction. Assisted conception: the induction of ovulation during infertility tratment can lead to theca lutein cysts and expansion of the ovarian volume predisposing to torsion. Fetal mortality up to 12% and occasional maternal mortality are reported. 1 – 4 While recurrence of HL in subsequent pregnancies has been reported in at least 3 cases, 1 1 8 we had none in our series. Conclusion(s): Ovarian torsion in pregnancy is more common in the first trimester, and induction of ovulation is a major risk factor. Ovarian torsion can be managed conservatively if diagnosed at an earlier gestational age. 2. Hence, ovarian torsion in pregnancy occurs most commonly in the first trimester, occasionally in the second, and rarely in the third. We aimed to evaluate the feasibility of prophylactic laparoscopic adnexal surgery during the late first trimester and second trimester for the prevention of adnexal torsion. Masses that persist into the second trimester are at risk for torsion, rupture, or labor obstruction. Abstract. Typically, the ovaries return to normal size during the first few months postpartum. When the enlarged ovaries are detected in the second trimester, some may continue to increase in size until delivery and, less often, others may revert to normal during the pregnancy. Thus, we can conclude that first trimester torsion is usually associated with cystic or multicystic ovaries (the latter most often found in patients treated by ovulation induction), and that the gradual regression of these ovarian cysts during the second and third trimester is connected to the lower risk of torsion. Incidence of ovarian surgery required in pregnancy is about 1:1312 pregnancies. The diagnosis is based on an awareness of the relevant risk factors, the clinical presentation, and a high index of suspicion. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women. A retrospective study was conducted at a tertiary center between January 2008 and January 2018. The median duration from admission to surgery was 6 hours (range, 1 hour to 3.7 days), being significantly shorter in the first trimester. It may present with nonspecific signs and symptoms, and should be considered in any female with acute abdominal pain. It can be intermittent or sustained and results in venous, arterial and lymphatic stasis. 31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The torsion of normal adnexa is rare during pregnancy, especially in the third trimester. No differences were observed in age, surgical history, presenting symptom, time from symptom onset to gynecologic ED admission, time from admission to surgery, affected side, No. [4] Differential diagnosis could be other acute abdominal conditions such as appendicitis, ureteral or renal colic, cholecystitis and bowel obstruction, non preganant horn of bicornuate uterus, appendiceal abscess and ectopic pregnancy. 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