OVARIAN TORSION AND OVARIOPEXY IN PREGNANCY

Yıl 2018, Cilt: 32 Sayı: 3, 269 - 274, 15.12.2018

Buğra Şahin Gizem Cura Fatih Çelik Banuhan Şahin

Öz

A patient, aged 28 years and 33
weeks of pregnancy, admitted to our center with severe left lower quadrant
pain. Ovarian torsion due to a 9 cm left ovary cyst was prediagnosed. The
patient underwent general anesthesia and was corrected for torsioned ovary,
blood was supplied, and the ovary was successfully fixed to the uterus by ovariopexy
in order to avoid recurrence of torsion. The baby was born with a cesarean
section. The patient was called to the control on the fifteenth day postop and
the blood flow was re-evaluated by doppler ultrasonography. Although antepartum
surgery is considered safe, abdominal surgery carries some risks for a pregnant
woman and the fetus. Therefore, the clinical decision should be made according
to the characteristics of the adnexal mass, the pregnancy week, pregnancy
expectancy and reperfusion of the ovary.

Anahtar Kelimeler

Ovarian torsion, ovariopexy, pregnancy

Gebelikte over torsiyonu ve ovaryopeksi

Öz

Yirmi sekiz yaşında, gebeliğinin 33.
haftasında olan bir hasta merkezimize ciddi sol alt kadran ağrısı ile başvurdu.
Dokuz cm boyutundaki sol over kistine bağlı over torsiyonu ön tanısı kondu. Genel
anestezi altında torsiyone over düzeltilerek kanlanması sağlandı ve tekrardan
torsiyone olmaması için ovaryopeksi operasyonu ile over uterusa sabitlendi.
Bebek sezaryen ile doğurtuldu. Hasta, post op on beşinci gününde kontrole
çağrıldı ve dopler ultrasonografi ile over kan akımı yeniden değerlendirildi.
Antepartum cerrahi müdahale güvenli kabul edildiği halde, abdominal cerrahi gebe
bir kadın ve fetus için bazı riskler taşır. Bu yüzden klinik karar, adneksiyal
kitlenin karakteri, gebelik haftası, gebelik beklentisi ve overin tekrar
kanlanmasına göre verilmelidir.

Anahtar Kelimeler

Over torsiyonu, ovaryopeksi, gebelik

Kaynakça

• Jeffcoate N. Torsion of the pelvic organs. Principles of Gynaecology. Butterworth & Co. Ltd London, 1975.280-282.
• Hoover K, Jenkins TR. Evaluation and management of adnexal mass in pregnancy. Am J Obstet Gynecol 2011;205:97-102.
• Huchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol 2010;150:8-12.
• Hasson J, Tsafrir Z, Azem F. Comparison of adnexal torsion between pregnant and nonpregnant women. Am J Obstet Gynecol 2010;202:536-539.
• Ashwal E, Krissi H, Hiersch L. Presentation, diagnosis, and treatment of ovarian torsion in premenarchal girls. J Ped Adoles Gynecol 2015;28:526-529.
• Vijayalakshmi K, Reddy GM, Subbiah VN, Sathşya S, Arjun B. Clinico-pathological profile of adnexal torsion cases: a retrospec¬tive analysis from a tertiary care teaching hospital. J Clin Diagn Res 2014;8:OC04-7.
• Born C, Wirth S, Stäbler A, Reiser M. Diagnosis of adnexal torsion in the third trimester of pregnancy: a case report. Abd Imag 2004;29:123-127.
• Mancuso A, Broccio G, Angio L. Adnexal torsion in pregnancy. Acta Obstet Gynecol Scand 1997;76:83–84.
• Glanc P, Salem S, Farine D. Adnexal masses in the pregnant patient a diagnostic and management challenge. Ultrasound Q. 2008;24:225-240.
• Morice P, Louis-Sylvestre C, Chapron C, Dubuisson JB. Laparoscopy for adnexal torsion in pregnant women. J Reprod Med 1997;42:435–439.
• Whitecar MP, Turner S, Higby K. Adnexial masses in pregnancy: A review of 130 cases undergoing surgical management. Am J Obstet Gynecol 1999;191:19-24.
• Bassi A, Czuzoj-Shulman N, Abenhaim HA. Effect of Pregnancy on the Management and Outcomes of Ovarian Torsion: A Population-Based Matched Cohort Study. J Minim Invasive Gynecol. 2018; 25: 1260-1265.
• Michel E. Rivlin. Surgery and Trauma in Pregnancy. In: Rivlin ME, Martin RW, Wiser WL (Eds). Manual of Clinical Problems in Obsterics and Gynecology, 5th Ed. Philadelphia, Lippincott Williams and Wilkins, 2000:126-130.
• Martin JR, Martin RW, Morrison JC. Surgical Diseases and Disorders in Pregnancy. In: Pernoll ML (Ed). Current Obstetric and Gynecologic Diagnosis and Treatment, 7th Ed. Connecticut, Appleton and Lange, 1991:480-492.
• Hasiakos D, Papakonstantinou K, Kontoravdis A, Gogas L, Aravantinos L, Vitoratos N. Adnexal torsion during pregnancy: report of four cases and review of the literature. J Obstet Gynaecol Res. 2008;34:683-687.
• McCrea RS. Uterine adnexal torsion with subsequent contralateral recurrence. J Reprod Med 1980;25:123–124.
• Germain M, Rarick T, Robins E. Management of intermittent ovarian torsion by laparoscopic oophoropexy. Obstet Gynecol 1996;88:715–717.
• Young R, Cork K. Intermittent Ovarian Torsion in Pregnancy. Clin Pract Cases Emerg Med. 2017;1:108-110.