1/3. Successful laparoscopic management of adnexal torsion during week 25 of a twin pregnancy.Adnexal torsion is a rare occurrence during pregnancy. Here we present a case of adnexal torsion during the 25th week of pregnancy, which was managed laparoscopically. The woman had achieved a successful twin pregnancy after in-vitro fertilization/intracytoplasmic sperm injection. She was admitted to the emergency department with acute abdominal pain. Abdominal ultrasound with colour Doppler mapping of the intra-ovarian blood flow showed adnexal torsion. Laparoscopic management was successfully carried out.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
2/3. Multiple pregnancy with adnexal torsion after in vitro fertilization: case report.Assisted reproductive techniques (art) are widely accepted procedures for infertile couples. Rare complications, like heterotopic pregnancy, bilateral tubal pregnancy, and adnexal torsion during pregnancy, have been diagnosed with increasing frequency after art. We present a case of an early triplet pregnancy complicated with adnexal torsion. The patient was pregnant through in vitro fertilization. Early ultrasound examination revealed a triplet pregnancy within the uterine cavity. At 7 weeks' gestational age, an acute onset of lower abdominal pain, progressive abdominal distension, and massive internal bleeding prompted emergency laparotomy. The right ovary was enlarged, twisted, necrotic and hemorrhagic. Attempts to preserve the ovary failed because of the friable nature of the affected ovary, and an oophorectomy had to be performed. Although the removed ovary contained a corpus luteum, the pregnancy continued smoothly after only short luteal support. A precise pre-surgery diagnosis in our case was difficult based on the patient's initial clinical presentation. However, with high clinical suspicion in addition to color Doppler ultrasound, the physician should be able to make an early decision for an exploratory laparotomy or laparoscopy, gaining the benefit of more conservative treatment.- - - - - - - - - - ranking = 5keywords = fertilization (Clic here for more details about this article) |
3/3. Laparoscopic unwinding of twisted ischemic hemorrhagic adnexum after in vitro fertilization.We present a case where, for the first time, unwinding of ischemic hemorrhagic adnexum was performed successfully through the laparoscope without the need to operate. Aspiration of ovarian fluid before detorsion facilitates the procedure; follow-up showed spontaneous follicular growth. We conclude that laparoscopic detorsion of ischemic adnexum is feasible. Apparently, oocytes are not damaged by the torsion and the ovary resumes normal function. This procedure should be considered in women during the reproductive age and in every case where malignancy can be ruled out.- - - - - - - - - - ranking = 4keywords = fertilization (Clic here for more details about this article) |