Effect of Pregnancy on the Management and Outcomes of Ovarian Torsion: A Population-Based Matched Cohort Study.

STUDY OBJECTIVE

To compare the treatment and surgical outcomes of ovarian torsion in pregnant and nonpregnant women.

DESIGN

A population-based matched cohort study (Canadian Task Force classification II.1).

SETTING

The United States Health Care Cost and Utilization Project Nationwide Inpatient Sample from 2003 to 2011.

PATIENTS

All cases of ovarian torsion among pregnant women and nonpregnant women with ovarian torsion (matched by age in a ratio of 1:1).

INTERVENTIONS

Outcomes of interest included the type of treatment received for ovarian torsion and the complications of surgery.

MEASUREMENTS AND MAIN RESULTS

There were 1366 women diagnosed with ovarian torsion among 8 532 163 pregnant women for an incidence of 1.6 in 10 000. Surgery was the predominant treatment, with laparotomy being more commonly performed on pregnant women versus nonpregnant women (57.0% vs 51.0%; odds ratio = 1.28; 95% confidence interval, 1.08-1.51; p < .01). Overall conservative management was less likely performed; however, it was more common among pregnant women versus nonpregnant women (odds ratio = 1.85; 95% confidence interval, 1.44-2.37; p < .01). In general, adverse events were uncommon in both groups although ovarian infarction was more commonly reported among nonpregnant women.

CONCLUSION

The diagnosis of ovarian torsion in pregnancy is rare. Compared with nonpregnant women, laparotomy and conservative management are more common among pregnant women. Treatment of ovarian torsion in pregnancy has comparable outcomes with treatment in nonpregnant women.