Ovarian torsion in the first stage of term labor
Dmitrienko K.V., Yavorskaya S.D., Ananyina L.P., Arinicheva A.V., Stroganova E.V., Bobrov I.P.
Background: Pregnancy and childbirth are risk factors for ovarian torsion. In pregnant women it occurs mainly in the first trimester and its rate does not exceed 6 cases per 10,000 pregnancies, which is 10–22% of the total number of appendiceal torsions. Despite the low incidence of this pathology during pregnancy, labor and postpartum, ovarian torsion may cause unfavorable perinatal (ante/intrapartum fetal death) and maternal outcomes (obstetric peritonitis); its diagnosis is difficult as the clinical picture of ovarian torsion during gestation is asymptomatic and nonspecific.
Case report: The article presents a clinical case of ovarian torsion during the first stage of term labor. A 36-year-old primiparous female patient had uterine contractions accompanied by persistent pain in the left lateral and subcostal regions, nausea and single vomiting within two hours after admission to the maternity ward. The laboratory examination showed only an increase in C-reactive protein up to 24 mg/L. The ultrasound examination revealed a mass in the left ovary, which suggested an acute abdomen associated with ovarian torsion. The patient had an emergency operative delivery; the exploration of the abdominal cavity confirmed the diagnosis.
Conclusion: Ovarian torsion in labor is a rare emergency situation in obstetrics and it is characterized by a subtle clinical picture, low informative value of laboratory and ultrasound data. A proper history taking (information about the ovarian mass that existed before pregnancy and was described by ultrasound in the first half of pregnancy) and high qualification of doctors who knew about the possibility of ovarian torsion with the mass inside the ovary during pregnancy and in labor made it possible to make a timely diagnosis and choose the right tactics.
Authors’ contributions: Dmitrienko K.V. – description of the clinical case, writing a literary reference; Yavorskaya S.D. – concept of work, data analysis, description of the clinical case, writing the text; Ananyina L.P. – final editing of the article; A.V. Arinicheva A.V. – description of operational tactics, operation execution, final editing of the article; Stroganova E.V. – drafting a manuscript; Bobrov I.P. – taking photographs, describing macro and micro preparations. The final version of the manuscript was approved by all authors.
Conflicts of interest: The authors declare that they have no apparent and potential conflicts of interest related to the publication of this article.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patient provided informed consent for the publication of her data and associated images.
For citation: Dmitrienko K.V., Yavorskaya S.D., Ananyina L.P., Arinicheva A.V.,
Stroganova E.V., Bobrov I.P. Ovarian torsion in the first stage of term labor.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (3): 213-218 (in Russian)
https://dx.doi.org/10.18565/aig.2024.300
Keywords
first stage of labor
acute abdomen
ovarian torsion
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Received 21.11.2024
Accepted 28.02.2025
About the Authors
Ksenia V. Dmitrienko, PhD, Teaching Assistant at the Department of Obstetrics and Gynecology with a course of APE, ASMU, Ministry of Health of Russia, 656038, Russia, Altai Territory, Barnaul, Lenin Ave., 40; obstetrician-gynecologist, Maternity Hospital No. 2, 656038, Russia, Altai Territory, Barnaul, Molodezhnaya str., 9, +7(962)810-17-52, tishovakseni@mail.ru, https://orcid.org/0000-0003-0886-4471Svetlana D. Yavorskaya, Dr. Med. Sci., Professor, Professor at the Department of Obstetrics and Gynecology with a course of APE, ASMU, Ministry of Health of Russia, 656038, Russia, Altai Territory, Barnaul, Lenin Ave., 40, +7(962)792-79-42, L2001@bk.ru, https://orcid.org/0000-0001-6362-5700
Lyudmila P. Ananyina, Chief Physician, Maternity Hospital No. 2, 656038, Russia, Altai Territory, Barnaul, Molodezhnaya str., 9, +7(3852)66-95-47, rd2bar@dravalt.ru
Alla V. Arinicheva, PhD, Head of the Gynecological Department, Maternity Hospital No. 2, 656038, Russia, Altai Territory, Barnaul, Molodezhnaya str., 9, +7(3852)38-08-38, alla.arinicheva@mail.ru, https://orcid.org/0009-0008-6204-606X
Elena V. Stroganova, PhD, Deputy Chief Physician for Medical Work, Maternity Hospital No. 2, 656038, Russia, Altai Territory, Barnaul, Molodezhnaya str., 9,
+7(3852)35-85-86, jazz200261@mail.ru
Igor P. Bobrov, Dr. Med. Sci., Professor at the Department of Forensic Medicine named after Prof. V.N. Kryukova and Pathological Anatomy with a course of APE, ASMU, Ministry of Health of Russia, 656015, Russia, Altai Territory, Barnaul, Lenin Ave., 40, +7(960)941-85-42, ig.bobrov2010@yandex.ru, https://orcid.org/0000-0001-9097-6733
Corresponding author: Ksenia V. Dmitrienko, tishovaksenia@mail.ru
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