Papa Dasari*

Senior Professor, Department of OBGY, JIPMER, Puducherry, India

*Corresponding Author: Papa Dasari, Senior Professor, Department of OBGY, JIPMER, Puducherry, India.

Received: July 11, 2022; Published: July 27, 2022

Abstract

A young primigravida at 10+4 weeks of gestation suffered from acute onset of pain abdomen of 4 days duration with vomiting. She was suspected to have torsion Ovarian cyst with pregnancy and undergone USG elsewhere which showed free fluid in abdomen and an echogenic adnexal mass along with intrauterine pregnancy and hence she was referred to our tertiary care Institute. After 12 hours of admission, she developed tachycardia and hypotension and had guarding and rigidity of abdomen. Abdominal USG showed left sided complex adnexal mass with absent arterial blood flow on Doppler. Live Intrauterine pregnancy corresponded to 9+2 weeks. Emergency Laparoscopy showed impending rupture of Ovarian mass which was edematous and bluish black with breach in the capsule and there was hemorrhagic fluid in pelvis. Detorsion was done successfully gently and cystectomy was deferred as it appeared very friable. Pregnancy support was given with vaginal progesterone and she was discharged after 5 days. She was followed up by teleconsultation due to COVID pandemic and she was admitted at 38 weeks with PROM and delivered an alive healthy male baby without any congenital malformations which weighed 2.8 kg.

Keywords: First Trimester; Pain Abdomen; Adnexal Mass; Torsion; Laparoscopy

References

1. Ali MK., et al. “Adnexal torsion in the first trimester of pregnancy: A case report”. Middle East Fertility Society Journal4 (2013): 284-286.
2. Halimeh R., et al. “Laparoscopic Adnexal Detorsion in a 20-Week Pregnant Patient: A Case Report and Literature Review”. Case Reports in Obstetrics and Gynecology (2019).
3. Bouguizane S., et al. “Adnexal torsion: A report of 135 cases”. Journal of Gynecology Obstetrics and Human Reproduction (Paris) 32 (2003): 535-540.
4. Smorgick N., et al. “Torsion of normal adnexa in postmenarcheal women: can ultrasound indicate an ischemic process?” Ultrasound in Obstetrics and Gynecology 31 (2008): 338-341.
5. Ding DC and Chang YH. “Laparoendoscopic single‑site surgical cystectomy of a twisted ovarian dermoid cyst during early pregnancy: A case report and literature review”. Gynecology and Minimally Invasive Therapy 5 (2016): 173‑17
6. Yen CF., et al. “Risk analysis of torsion and malignancy for adnexal masses during pregnancy”. Fertility and Sterility 91 (2009): 1895‑1
7. Vijayaraghavan SB. “Sonographic whirlpool sign in ovarian torsion”. Journal of Ultrasound in Medicine12 (2004): 1643-1649.
8. Feng JL., et al. “Comparison of ovarian torsion between pregnant and non-pregnant women at reproductive ages: sonographic and pathological findings”. Quantitative Imaging in Medicine and Surgery 1 (2020): 137-147.
9. Pearl J., et al. “Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy”. Surgical Endoscopy11 (2011): 3479-3492.
10. Surducki D. “Case report of ovarian torsion in the first trimester of pregnancy”. Journal of Gynecological Research and Obstetrics1 (2020): 008-9.
11. Alalade A and Abdelmagied A. “Torted benign ovarian cyst in the first trimester. The gynaecologist’s dilemma”. Gynecological Surgery3 (2011): 347-348.
12. Mathew M., et al. “Conservative management of twisted ischemic adnexa in early pregnancy”. Annals of Medical and Health Sciences Research 2 (2015): 142-144.
13. Bras R., et al. “Adnexal torsion in the first trimester of pregnancy: diagnosis, laparoscopic management, and review of the literature”. Surgical Technology International 30 (2017): 210-214.
14. Zhan RX., et al. “Successful laparoscopic management of ovarian cyst torsion in the third trimester”. Chinese Medical Journal (Engl)3 (2020): 375-377.

Citation

Citation: Papa Dasari. “Torsion Ovarian Cyst with Impending Rupture During Early Pregnancy and Outcome of Laparoscopic Management". Acta Scientific Women's Health 4.8 (2022): 64-67.

Copyright

Copyright: © 2022 Papa Dasari. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.