Department of Obstetrics and Gynecology, the Chaim Sheba Medical Center, Ramat-Gan, Israel.
Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Int J Gynaecol Obstet. 2021 Dec;155(3):411-416. doi: 10.1002/ijgo.13660. Epub 2021 Apr 19.
To develop a risk score for preoperative prediction of recurrent adnexal torsion (rAT) among women with a history of previous adnexal torsion (AT).
A retrospective cohort study. We included women with a history of AT, presenting with suspected rAT who underwent diagnostic laparoscopy between March 2011 and March 2020. We compared women with rAT to those without. We constructed a prediction score and validated it in a prospectively collected cohort between April 2020 and June 2020.
One hundred and fifteen women composed the study cohort. Recurrent AT was confirmed laparoscopically in 86 (74.8%) cases. A risk score for rAT was developed, based on three associated factors: enlarged ovary, no previous oophoropexy and current IVF treatment. In the construction cohort, the rate of torsion was 44.4%, 67.9%, 82.9% and 100% if none, one, two, or three risk factors were present, respectively. In the prospective validation of the risk score, the prediction of one and two risk factors was 60.0% and 100% respectively.
Enlarged ovary is independently associated with preoperative rAT diagnosis. Coupled with information regarding the previous surgical approach in previous AT and current IVF use, these factors could be used to efficiently predict rAT among women with a previous AT.
开发一种术前预测有卵巢扭转病史的女性复发性附件扭转（rAT）的风险评分。
这是一项回顾性队列研究。我们纳入了既往有卵巢扭转病史，表现为疑似 rAT 并在 2011 年 3 月至 2020 年 3 月间接受诊断性腹腔镜检查的女性。我们将 rAT 患者与无 rAT 患者进行比较。我们构建了一个预测评分，并在 2020 年 4 月至 6 月间前瞻性收集的队列中进行了验证。
共有 115 名女性组成了研究队列。86 例（74.8%）经腹腔镜证实为复发性 AT。基于三个相关因素（卵巢增大、既往未行卵巢固定术和当前 IVF 治疗），我们开发了 rAT 的风险评分。在构建队列中，如果不存在、存在 1 个、2 个或 3 个危险因素，扭转的发生率分别为 44.4%、67.9%、82.9%和 100%。在风险评分的前瞻性验证中，1 个和 2 个危险因素的预测率分别为 60.0%和 100%。
卵巢增大与术前 rAT 诊断独立相关。结合既往 AT 手术方式和当前 IVF 使用的信息，这些因素可用于有效预测既往有卵巢扭转病史的女性 rAT。
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