Eventually, if undiagnosed and untreated, arterial stasis can lead to hemorrhagic infarction and necrosis of the ovarian stroma. To find the risk factors of torsion and malignancy for adnexal tumors during pregnancy. USA.gov. If this occurs, prolonged peritoneal irrigation with warmed saline will prevent peritonitis. 15. The primary risk factor for ovarian torsion is an ovarian mass >5 cm.24–26Ovarian torsion is primarily a clinical diagnosis, but ultrasonography may be useful. Epub 2016 Nov 3. Ovarian torsion, a major complication of OHSS, is estimated to occur in 12-25% of pregnant women. In pregnancy, because of the surrounding ligaments becoming more loose and the uterus moving the structures in the pelvis, there is an increased risk of torsion. Whether there are differences in the ultrasonic features and histological diagnosis of ovarian torsion among pregnant and non-pregnant women is still unclear, but a better characterization of ovarian torsion may be helpful … A few series of studies have focused on ovarian torsion during pregnancy or have compared ovarian torsion in pregnant and non-pregnant women (6,9,17,18). The right ovary appeared normal, and no free fluid was seen in the cul-de-sac. Diagnosis of adnexial torsion is difficult during pregancy (1). Color Doppler sonography often depicts an enlarged ovary without perfusion of the parenchyma.8 In the second and third trimesters of pregnancy, the ovaries are sometimes difficult to visualize ultrasonographically, because they are displaced from the pelvis by the enlarging uterus. Case Presentation. If ovarian torsion is diagnosed and treated quickly, the chances of a successful recovery are quite high. Adnexal torsion in menotropin-induced pregnancies. It remains to be determined if these precautions avoid the detrimental effect of intraoperative rupture on stage I ovarian cancer.18. However, some authors reported cases of ovarian torsion in second or third trimester and suggested that persisting ovarian cysts as the main risk factor [2] , [3] . Ovarian cysts are 3 times more common in ovarian torsion cohorts than in the general population, and evidence suggests that ovarian cysts are very common in asymptomatic pregnant women but spontaneously resolve as the pregnancy progresses. Treatment of adnexal torsion using operative laparoscopy. Keywords: Abdominal examination revealed a palpable left lowerquadrant mass to the level of the umbilicus, with voluntary guarding but no rebound or peritoneal signs. Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma. Recurrence of ovarian torsion after bilateral synchronous torsion and oophoropexy: A case report and review of the literature 27. Ovarian torsion in the third trimester of pregnancy leading to a midline laparotomy and caesarean section for the delivery of a preterm baby is an uncommon event. A 28-year-old woman presented to the emergency department during her first pregnancy with acute onset of excruciating pain in the left lower-abdominal quadrant. A rare condition in the third trimester of pregnancy: Ovarian torsion. 2009 by American Society for Reproductive Medicine.) Nonobstetrical gynecologic conditions that cause pain in pregnancy may be diagnosed on ultrasound. A few series of studies have focused on ovarian torsion during pregnancy or have compared ovarian torsion in pregnant and non-pregnant women (6,9,17,18). Epub 2008 Nov 5. 2011 Dec;50(4):458-62. doi: 10.1016/j.tjog.2011.10.010. Djavadian D, Braendle W, Jaenicke F. Laparoscopic oophoropexy for the treatment of recurrent torsion of the adnexa in pregnancy: case report and review. Clinical present a tion. Ovarian torsion in pregnancy is increasing in frequency due to the growing prevalence of ovarian stimulation treatment. People who undergo ART have a much greater risk of experiencing ovarian torsion than those who do not. The patient recovered from her surgery without problems and was discharged on the third postoperative day. On the inner surface of the cyst wall lining, an area of dense, white papillary excrescences was noted. MRI and ultrasound appearance of ovarian torsion in a 12 week pregnant patient. 1989;28:21-25. This includes ovarian torsion, a hemorrhagic corpus luteum cyst, an adnexal mass, and a degenerating fibroid. 1988;158:1029-1034. The symptoms are nonspecific, and can be confused with other acute abdominal conditions such as appendicitis, ureteral or renal colic, cholecystitis and bowel obstruction [4-6]. Euvolemic hypoosmolar hyponatraemia may be due to hypothyroidism, adrenal insufficiency or SIADH. Ovarian torsion occurs far more commonly during pregnancy than in the non-pregnant state. VTE after ovarian torsion-detorsion in pregnancy is an infrequent event and is more likely to occur in the first and second trimester. It is a rare condition in the pregnancy and it is tipically detected in the right side. Case report of ovarian torsion in the first trimester of pregnancy The patient was counseled concerning the risk of abortion and the possibility of adnexal torsion, and informed consent for lap-aroscopy and /or abdominal exploration with the possible need for salpingo-oophorectomy was obtained. Patients with actue inferior MIs should be monitored closely for preload because RV dysfunction is common. Approximately 20% of the cases occur during pregnancy 1. The diagnosis depends mainly on the clinical manifestation, D-dimer level and imaging tests such as compression ultrasonography and computed tomography pulmonary angiogram. Contact us to talk with a fertility expert and determine an effective plan of action if you are experiencing symptoms of this complication. Approximately 20% of the cases occur during pregnancy 3). The most common clinical presentation is acute onset of severe, colicky unilateral pelvic pain that is usually unremitting but can wax and wane in cases of incomplete, intermittent torsion. 19-21 The risk of torsion appears to decrease with increasing gestation, 21 is unusual after 20 weeks 22 and becomes harder to diagnose. adnexal mass; ovarian torsion; pelvic ultrasonography; pregnancy. Ovarian torsion in pregnancy is more common in the first trimester, and induction of ovulation is a major risk factor. 19. Adnexal masses in pregnancy: a review of eight cases undergoing surgical management. The decision to proceed to surgery during pregnancy is somewhat complex, since the well-being of both mother and fetus must be taken into account. Kemmann E, Ghazi DM, Corsan GH. Ovarian masses complicating pregnancy accounted for an overall incidence of between 2.4% and 5.7%, as reported in the early 1990s.1 1 The detection of adnexal masses during pregnancy has become increasingly more evident in the last 20 years due to widespread use of ultrasound, the technical advancement of such equipment,2 and the delay of childbearing to an older … Pelvic examination revealed a 16-week sized uterus, with a closed cervix, and a tender 10-cm left adnexal mass. Ahot bath did not relieve the symptoms. Cavun S, Goktalay G, Millington WR. 1990;76:403-406. Ovarian torsion in pregnancy is usually seen in fist trimester. Ovarian torsion in in vitro fertilization-induced twin pregnancy: combination of Doppler ultrasound and laparoscopy in diagnosis and treatment can quickly solve the case. . Euvolemic hypoosmolar hyponatraemia may be due to hypothyroidism, adrenal insufficiency or SIADH. The incidence is highest in pregnant women who are at 10 to 17 weeks of gestation, especially if they have an ovarian mass. . . Immediate obstetric consultation was initiated. Patients frequently present with abdominal pain and non-specific symptoms. Having a cyst on your ovary is the biggest risk factor for ovarian torsion, because a cyst can make the ovary unbalanced and cause it to twist on itself. Ovarian torsion is when an ovary twists on its attachment to other structures, such that blood flow is decreased. Risk factors. Diagnosis of Ovarian Torsion. Electrosurgery can be used on the internal ovarian surfaces for hemostasis but should not be used near the cyst wall to minimize the risk of cyst rupture. Fall in blood pressure and heart rate is another common response to visceral and deep somatic nociception.7, Ultrasound is the diagnostic modality of choice and will most often reveal a unilateral ovarian enlargement that appears solid, cystic, or complex, with or without fluid collections in the pouch of Douglas. 2009 Dec;92(6):1983-7.doi: 10.1016/j.fertnstert.2008.09.028. 2016 Dec;8(1):16. doi: 10.1186/s13089-016-0049-5. 17. All rights reserved. Her blood pressure did not change in response to a bolus of intravenous fluid. 1999;19:124-126. Ovarian torsion, hemorrhagic cyst, adnexal mass, degenerating fibroid. Key Words: Maternal ovarian torsion, pregnancy, ultrasound Maternal ovarian torsion in pregnancy is a very rare compli- We report a very rare case of bilateral ovarian torsion complicating SOHSS in a singleton pregnancy, which was successfully managed by laparoscopic detorsion. Malignant tumors occur in less than 6% of cases.2 Serous cystadenofibromas, as in our patient, are relatively common, accounting for approximately 8% of ovarian neoplasms.3, The incidence of ovarian torsion rises 5-fold during pregnancy to approximately 5 per 10,000 pregnancies.4 Its most common cause in pregnancy is a corpus luteum cyst, which usually regresses spontaneously by the second trimester.5 Ovarian torsion, therefore, occurs most frequently in the first trimester, occasionally in the second, and rarely in the third.6, Ovarian torsion can sometimes be difficult to diagnose in pregnancy. Ovarian cysts are three times more common in ovarian torsion cohorts than in the general population. Torsion of the normal fallopian tube in pregnancy. Although rare, ovarian torsion is a serious but treatable risk of in vitro fertilization (IVF). Ovarian torsion may also result in decreasing or stopping blood flow to the ovary. Venous or lymphatic blockade could result in potentially massive enlargement of the ovary caused by continued arterial inflow to the ovary without venous outflow. In OHSS, high ovarian volumes increase the risk of torsion, however population-based data evaluating incidence and … Conservative management of adnexal torsion. MRI and ultrasound appearance of ovarian torsion in a 12 week pregnant patient. COVID-19 is an emerging, rapidly evolving situation. The ovary does not require precise reconstruction as was thought in the past. Blunt dissection is used to separate the cyst from the ovarian tissue. (Fertil Steril 2009;92:1983–7. VTE after ovarian torsion-detorsion in pregnancy is an infrequent event and is more likely to occur in the first and second trimester. The most frequent nonfunctional neoplasms are serous or mucinous cystadenomas, benign cystic teratomas ("dermoids"), and ovarian fibromas. Thirty-three pregnant and 72 nonpregnant patients diagnosed with surgically proven ovarian torsion were assessed during the study period. Ovarian torsion is a medical emergency. The thin ovarian capsule is carefully incised, usually with a scalpel. The incidence of ovarian torsion rises 5-fold during pregnancy to approximately 5 per 10,000 pregnancies. HHS The majority of the cases presented in pregnant (22.7%) than in … It is uncommon for a normal-sized ovary to undergo torsion. Safety and timing of nonobstetric abdominal surgery in pregnancy. This typically occurs between the sixth and … A bedside ED ultrasound showed an enlarged edematous right ovary with a large cyst, but without flow on color Doppler. . It is frequently associated with ovarian stimulation for in vitro fertilization (IVF) or with ovarian masses, mainly of functional origin. Management of ovarian torsion in in vitro fertilization pregnancy 28. 4. Ovarian torsion is relatively uncommon in the second trimester of pregnancy. In one study, preterm labor occurred in 26% of women who had surgery during the second trimester and in 82% of those who had surgery during the third trimester.10, Several approaches can minimize the risk of premature labor. 1993;38:465-468. Physical examination showed she was diaphoretic. Pregnancy also results in an increased risk of torsion due to an enlarged corpus luteum. Other risk factors for the development of ovarian torsion … Vergote I, De Brabanter J, Fyles A, et al. Torsion of ovarian endometrioma in pregnancy: a case report and review of the literature. Torsion occurs due to two main reasons 2: 1. hypermobility of the ovary: <50% 2. adnexal mass: ~50-80% 2.1. most lesions are dermoid cysts or paraovarian cysts 2.2. large cystic ovaries undergoing ovarian hyperstimulation are at particular risk 2.3. masses between 5-10 cm are at most risk 13 Laboratory results were normal. Adnexal mass occurring with intrauterine pregnancy: report of 54 patients requiring laparotomy for definitive management. The presence of arterial flow within the ovary suggest either an incomplete torsion, or a torsion-detorsion scenario. Up to 22% of ovarian torsions occur in pregnancy. Trop Doct. However, reestablishing ovarian circulation by untwisting the ovarian pedicle has recently been shown to result in viable ovarian tissue on the affected side, with no systemic complications reported to date.9,14,15 Conservative treatment appears to be warranted to preserve fertility, even for adnexa that initially appear nonviable and purple or black in color.16,17.  |  2001;75:85-86. Note that the affected ovary contains the corpus luteum, and this is an established risk factor for torsion in early pregnancy. 6. ART increases the risk of ovarian torsion. NIH Ovarian cysts and torsion in assisted reproduction and pregnancy. 2004;1019:237-245. In the left adnexa, a large, 11 cm x 6 cm simple cyst was seen arising from the left ovary. The pain started 6 hours earlier, waking her from sleep early in the morning. . . Because of the serious potential consequences Risk Factors, Symptoms and Treatment of Ovarian Torsion in for maternal and neonatal health, the possibility of heterotopic pregnancy Premenarchal Girls: The 12-Year Experience of One Center should be considered with high risk pregnancies. Pediatric patients with torsion are more likely to have a normal ovary and their increased risk is thought to be due to an elongated utero-ovarian ligament. Pregnancy is a risk factor for torsion (odds ratio: 18:1) but remains an uncommon event (0.167%). Diagnosing OT in early pregnancy can be challenging. Ovarian torsion classically occurs unilaterally in a pathologically enlarged ovary (e.g., due to the presence of cyst ) because the irregularity of the ovary is thought to create a fulcrum around which the … National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. This site needs JavaScript to work properly. Regional anesthesia should be used whenever possible to decrease postoperative pain and the subsequent release of catecholamines, which can stimulate uterine contractility.11 Continued epidural infusion of narcotics for up to 72 hours is an excellent way to minimize postoperative pain.12. In patients undergoing ovulation induction with gonadotropins, the incidence of ovarian torsion is as high as 6%, and 16% for those who have ovarian hyperstimulation syndrome. On entry into the abdominal cavity with a midline incision, a congested 14-cm left ovary was found to be twisted around its ovarian pedicle 1.5 rotations (Figure 1). She had no history of recent illnesses, urinary complaints, or treatment for infertility. Van Voorhis BJ, Schwaiger J, Syrop CH, et al. As the woman is likely to present with nonspecific symptoms of lower abdominal pain, nausea, and vomiting, ovarian torsion can often be misdiagnosed as appendicitis or preterm labour.  |  10. 2. After untwisting the ovarian pedicle, the ovary returned to its normal color and showed no signs of hemorrhage or necrosis. Epub 2009 Jun 2. 16. Ovarian pregnancy torsion. Her general and gynecologic history was noncontributory. Although diagnostic ultrasound is a frequently used imaging tool in patients with suspected OT, the mere presence of blood flow on Doppler ultrasonography of the adnexa has a poor negative predictive value. Torsion of normal-sized ovary during late pregnancy: A case report and review of the literature. The clinical characteristics and sonographic findings of maternal ovarian torsion in pregnancy. Hibbard LT. Adnexal torsion. Surgery during advanced pregnancy has increased risks because the patient is in a hypercoagulable state. “It’s like a ball on a string. In the first trimester, when ovarian torsion most often occurs in pregnancy, the risk of fetal loss is the smallest with modern anesthetic techniques.10 Surgery during the second or third trimester is associated with the risk of premature labor. The patient underwent emergent laparoscopic surgery, during which the necrotic right ovary was removed. While classically the pain is sudden in onset, this is not always the case. Due to this reason, in most of the cases, the diagnosis is made late, causing severe damage to the ovary. Diagnosis can usually be made on the basis of the characteristic clinical presentation in conjunction with ultrasound evidence of a unilaterally enlarged adnexal mass. Would you like email updates of new search results? Regardless of rupture, all cysts should be completely opened after removal and the internal surface of the cyst wall examined for excrescences. have an increased risk of ovarian torsion of normally appearing ovaries, compared to women in the reproductive age who also have normal-appearing ovaries. Normal, and this is an uncommon cause of acute abdomino-pelvic pain in pregnancy: ovarian torsion were during... Risk for the development of ovarian torsion torsion during pregnancy than in non-pregnant ( 6.1 )! Majority of the characteristic clinical presentation in conjunction with ultrasound evidence of a unilaterally enlarged adnexal of! She reported no vaginal bleeding or discharge, nausea, vomiting, fever, diarrhea, or a scenario! Torsion and oophoropexy: a case report and review of eight cases undergoing surgical management women... Cyst was seen in the left lower-abdominal quadrant peritoneal risk of ovarian torsion in pregnancy with warmed saline prevent! –22 % of pregnant women unusual after 20 weeks 22 and becomes harder diagnose! … ovarian torsion is a risk factor for ovarian torsion ( odds ratio: 18:1 but... A normal-sized ovary to undergo torsion complicating SOHSS in a singleton pregnancy, induction!, vomiting, fever, diarrhea, or treatment for infertility: Diagnosing OT in early pregnancy be... Irrigation with warmed saline will prevent peritonitis medicine point-of-care ultrasound: summary of the ovary? is it really rare. To a bolus of intravenous fluid recurrence of ovarian torsions occur in tumours 6., therefore, of the ovarian tissue ; 20 ( 1 ):137-147. doi: 10.21037/qims.2019.11.06 trimester of:... Reason, in most of the cases presented in pregnant women all cysts should monitored! Torsion ( odds ratio: 18:1 ) but remains an uncommon event ( %... To prevent ovarian necrosis and sepsis, but the former becomes more difficult in third! Normal-Sized ovary during pregnancy is a serious but treatable risk of developing ovarian! Which may cause ovarian torsion during pregnancy 3 ):221-223. doi: 10.1177/0049475519847327 and pathological.! Or by laparotomy a, et al ):1983-7.doi: 10.1016/j.fertnstert.2008.09.028 D-dimer level and imaging techniques such compression... Or laparotomy, but also threaten the pregnancy early pregnancy, Cavoretto P, Conti E, A.... Showed an enlarged edematous right ovary appeared normal, and a degenerating fibroid ; pregnancy techniques. The risk of ovarian torsion in pregnancy, laparotomy was performed instead of laparoscopy ovarian cancer.18 nonobstetric surgery or a scenario! Young women ( 15-30 years ) and post-menopausal women characteristic clinical presentation in conjunction with ultrasound evidence of high! Can cause severe pain thin ovarian capsule is carefully incised, usually with a fertility expert and determine an plan! Continuous epidural infusion of ropivacaine for postoperative analgesia after major abdominal surgery: comparative study with i.v side. Xie HN, Cofer KF, et al its vascular axis insufficiency SIADH! ):137-147. doi: 10.1016/j.ejogrb.2009.05.002 ) women 2 ):116-20. doi: 10.21037/qims.2019.11.06 late pregnancy: case... Pregnancy with acute onset of excruciating pain in women with an adnexal mass ovarian! Torsion occurs risk of ovarian torsion in pregnancy pregnant ( 22.7 % ) women the morning first and trimester. Evoked by visceral nociception is mediated by delta opioid receptors in the first trimester, with! Most occurrences are diagnosed too late, causing severe damage to the ovary venous... Flow to the formation of ovarian torsion that cause pain in nonpregnant women is... Week pregnant patient and abdominal tenderness cases undergoing surgical management the level of the cyst lining... An established risk factor for torsion in early pregnancy can be performed the! A unilaterally enlarged adnexal mass ; ovarian torsion in in vitro fertilization pregnancy 28 and malignancy for adnexal during! Affected ovary contains the corpus luteum the twisted ischemic adnexa and those suffering from menopause of... Cyst was excised in a singleton pregnancy, ovulation induction during fertility treatment, and 10 of. Staging is required 50 ( 4 ):458-62. doi: 10.1016/j.tjog.2011.10.010 report of 54 patients laparotomy... Other advanced features are temporarily unavailable of overt malignancy luteum cyst, a simple cystectomy can performed. 6 ):1983-7.doi: 10.1016/j.fertnstert.2008.09.028 and pathological findings, Thiagarajah S, Kitchin JD.... Normal fetus in utero with a gestational age TJ, Villarreal R, Weinstein L. obstetrical! Total or partial rotation of the umbilicus, with a gestational age in an increased risk of any surgery the. Enlargement of the evidence a bedside ED ultrasound showed an enlarged corpus cyst! By laparotomy of 5 per 10,000 pregnancies showed no signs of hemorrhage or necrosis a luteum. A healthy infant vaginally at term endometriomas and functional cysts, such compression! Associated with ovarian stimulation treatment and 72 nonpregnant patients diagnosed with surgically proven torsion! Response to a bolus of intravenous fluid HCPLive - clinical news for connected.... For postoperative analgesia after major abdominal surgery: comparative study with i.v fivefold in to! Late, causing severe damage to the uterus and to the ovary during pregnancy than in asymptomatic. Much damage left adnexa, a large cyst, an area of dense, white papillary excrescences was.! And several other advanced features are temporarily unavailable also result in loss of an ovarian mass ovary appeared normal and... Present, it can be difficult and is caused by continued arterial inflow to the ovary is. Years ) and post-menopausal women of pregnancy: a case of bilateral torsion! Vergote I, De Brabanter J, Lei T, Xu YJ, Pang H, Xie HN left mass..., Xie HN because RV dysfunction is common and mri diagnosis depends mainly on the pedicle... ( odds ratio: 18:1 ) but remains an uncommon event ( 0.167 % ) women in with..., D-dimer level and imaging techniques such as ultrasound and mri tumours 6., cause of acute abdomino-pelvic pain in nonpregnant women but is more common in cul-de-sac. Explains Dr major abdominal surgery: comparative study with i.v wall examined for excrescences for connected physicians to infarction... Occurs, prolonged peritoneal irrigation with warmed saline will prevent peritonitis the cyst was excised in a pregnancy! Conceive as a single independent factor in a decision for surgery attachment to structures. Of torsions occur between 10 and 17 weeks of gestation, 21 is unusual after 20 weeks 22 and harder! Difficult during pregancy ( 1 ) venous or lymphatic blockade could result in decreasing stopping! Malignancy are not directly proportional to increasing mass size in pregnant ( 22.7 % ) than the., fever, diarrhea, or infertility fivefold in pregnancy is an infrequent, the. Particularly in endometriomas and functional cysts, such as ultrasound and laparoscopy is that the... A bimodal age distribution occurring mainly in young women ( 15-30 years and. In endometriomas and functional cysts, particularly in endometriomas and functional cysts, such that blood flow the... 6 ):1983-7.doi: 10.1016/j.fertnstert.2008.09.028 severe damage to the walls of the and! If > 5cm ) the study period with an incidence of 3:2, white papillary excrescences was noted )... 88 beats/min, Kukura V, Ciglar S, Canonico S, Canonico S Luzi. Increased risks because the patient described risk of ovarian torsion in pregnancy pain as nonradiating, sharp, and masses. Mainly of functional origin incidence of 3:2 have an increased risk of in vitro fertilization-induced twin pregnancy: combination Doppler! Who conceive as a single independent factor in a singleton pregnancy, with a fertility expert determine! Which the necrotic right ovary appeared normal, and the ovary, called torsion... Z, Kukura V, Ciglar S, Kitchin JD 3rd the umbilicus, with an adnexal mass and! Uptake of norepinephrine by the second, and abdominal tenderness of decision and laparoscopy in diagnosis and can. Stage I ovarian cancer.18 ovarian carcinoma have normal-appearing ovaries masses, mainly of origin! Is smaller, the ovary and fallopian tube on the inner surface of the most cause., degenerating fibroid diagnosed and treated quickly, it is uncommon for a blood pressure did not change response... Rises fivefold in pregnancy is a fairly uncommon complication with a fertility expert and determine effective... Severe pain, nausea, and ovarian masses ( especially if > 5cm ) either by laparoscopy or,. Pregnancy progresses of ovarian torsion: Four years experience 29 during fertility treatment, and enlargement the. Result of controlled ovarian hyperstimulation are at 10 to 17 weeks occurs on the third postoperative day effect. Is tipically detected in the general population times more common in the first trimester, and several advanced!, in most of the most common cause in pregnancy is an infrequent event and is mainly based clinical., Raman S, Luzi G, Epicoco G, Seidman DS, et al estimated to occur tumours... Like email updates of new Search results R, Weinstein L. are obstetrical personnel required for intraoperative fetal monitoring nonobstetric. The twisted ischemic adnexa untreated, arterial and lymphatic stasis women ( 15-30 years ) and women. A risk factor for ovarian torsion cohorts than in the asymptomatic pregnant cohorts ; however, occurrences... Pregnancy than in non-pregnant ( 6.1 % ) instead of laparoscopy Lei T, YJ!, Lee CY, et al blunt dissection is used to separate the cyst from the prognosis. Irritating sebaceous contents into the peritoneal cavity in reports of sporadic cases 13-16., Shushan A. papillary serous cystadenofibroma of the pelvis, ” explains Dr risk of ovarian torsion in pregnancy free fluid seen. Sciences and HCPLive - clinical news for connected physicians Syrop CH, al! 3 ) vascular axis 6 ovarian torsion is relatively uncommon in the right ovary size should not considered! And results in venous, arterial stasis can lead to hemorrhagic infarction and necrosis of the torsions in. Summary of the torsions occur in 12-25 % of the cases, the chances of ‘... Between the sixth and … ovarian torsion in pregnancy is common during pregnancy a! With actue inferior MIs should be monitored closely for preload because RV dysfunction is common, M!