Journal of International Obstetrics and Gynecology ›› 2020, Vol. 47 ›› Issue (6): 716-720.

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Diagnosis and Treatment of Adnexal Torsion during Pregnancy

YU Jing-jing, LIU Xiao-hui, LI Xiao-xiao, XIE Ya-wen, TIAN Geng   

  1. Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun 130000, China
  • Received:2020-04-30 Revised:2020-06-23 Published:2020-12-15 Online:2020-12-11
  • Contact: TIAN Geng, E-mail: tiangeng71@ foxmail.com E-mail:tiangeng71@foxmail.com

Abstract: Adnexal torsion refers to axial rotation of the ovary or fallopian tube and its ligaments on its blood vessels, which is a rare gynecologic emergency. Delayed treatment can lead to abortion, premature delivery, hemorrhage and infection, which threats the safety of mother and fetal life and female fertility. Thus, we need early diagnosis and treatment for it. Ovarian hyperstimulation caused by assisted reproductive technology and ovarian masses are the most common causes of adnexal torsion. The clinical manifestations and laboratory tests of adnexal torsion were not specific. The most common symptoms are acute or subacute lower abdominal pain, followed by nausea and vomiting. Ultrasound can be used to diagnose torsion in the first trimester. "Whirlpool sign" of twisted vascular pedicle is the specific finding. In the second and third trimester of pregnancy, it is difficult to diagnose because of uterine occlusion while MRI is of high diagnostic value. And the diffusion-weighted imaging can be used to assess the severity of adnexal torsion. At present, the treatment methods for the adnexal torsion during pregnancy include manual reduction and surgical treatment. Operation is the main diagnosis and treatment method of adnexal torsion during pregnancy. Laparoscopic conservative treatment is of great significance for achieving a good outcome of mother and child and saving female fertility.

Key words: Pregnancy;, Adnexa uteri;, Torsion abnormality;, Diagnosis;, Conservative treatment