Critical Care Obstetrics and Gynecology

Laparoscopic Management of Bilateral Ovarian Torsion Following Ovarian Hyperstimulation Syndrome in a Twin Pregnancy

Ovarian accidents requiring surgical intervention during pregnancy should be accurately evaluated to identify the patients who need prompt surgical interventions from those where a “wait-and-see” strategy can be followed. The benefits and safety of minimally invasive surgery are well known in non-pregnant patients, but during pregnancy the risks of laparoscopic approach seems to increase. This is the first case reported in the international literature with bilateral ovarian torsion following ovarian hyperstimulation syndrome in a twin pregnancy, which was successfully managed by laparoscopic ovarian detorsion and unilateral adnexectomy. Increasing evidence suggests that laparoscopic treatment of adnexal masses in pregnancy is safe and effective although it is a surgical challenge with difficulty level that increases with gestational age. For this reason, laparoscopic surgery during pregnancy should be reserved for experienced surgeons able to reduce the additional risks and operating time.

Author(s):

Flavio Grauso, Giuseppe Rosario Lannino and Ciro Perone

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