Perioperative Outcomes in Pregnant Women Who Underwent Surgery for Adnexal Torsion

Abstract

Objective To evaluate clinical characteristics, maternal and fetal outcomes in pregnant women who underwent surgery for adnexal torsion (AT).

Methods All patients, who underwent surgical operation due to AT during pregnancy at the Department of Obstetrics and Gynecology, School of Medicine, Ege University between 2005 and 2020 were retrospectively investigated. Main clinical and perioperative outcomes were evaluated.

Results A total of 21 patients who underwent surgery due to AT during pregnancy were included. Of all patients, 61.9% underwent laparoscopy and the remaining 38.1% underwent laparotomy. The most common surgical procedure was adnexal detorsion in both groups (48%). Mean gestational age at the time of diagnosis, duration of surgery and hospitalization were significantly lower in the laparoscopy group, when compared with the laparotomy group (p = 0.006, p = 0.001, and p = 0.001, respectively.) One of the patients had an infection during the postoperative period. Spontaneous abortion was only observed in one case.

Conclusion It can be concluded that the surgical intervention implemented for the exact diagnosis and treatment of AT (laparotomy or laparoscopy) did not have an unfavorable effect on pregnancy outcomes such as abortion, preterm delivery, and fetal anomaly. However, laparoscopy may be superior to laparotomy in terms of advantages.

Resumo

Objetivo Avaliar as características clínicas, e os desfechos maternos e fetais em gestantes submetidas à cirurgia de torção anexial.

Métodos Todas as pacientes operadas por torção anexial durante a gravidez no Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de Ege entre 2005 e 2020 foram investigadas retrospectivamente. Os principais resultados clínicos e perioperatórios foram avaliados.

Resultados Foram inclusas 21 pacientes operadas por torção anexial durante a gravidez. De todos as pacientes, 61,9% foram submetidas à laparoscopia e as 38,1% restantes foram submetidas à laparotomia. O procedimento cirúrgico mais comum foi apenas a destorção anexial em ambos os grupos (48%). A idade gestacional média no momento do diagnóstico, a duração da operação e da hospitalização foram significativamente menores no grupo de laparoscopia em comparação com o grupo de laparotomia (p = 0,006, p = 0,001 e p = 0,001, respectivamente.) Uma das pacientes teve uma infecção no pós-operatório. Apenas em um caso observamos aborto espontâneo.

Conclusão Pode-se concluir que a intervenção cirúrgica implementada para o diagnóstico exato e tratamento da torção anexial (laparotomia ou laparoscopia) não teve efeito desfavorável nos desfechos da gravidez, como aborto, parto prematuro e anomalia fetal. No entanto, a laparoscopia pode ser superior à laparotomia em termos de vantagens.

Keywords

adnexal torsion - pregnancy - emergent surgery - perinatal outcomes

Palavras-chave

torção anexial - gravidez - cirurgia emergente - resultados perinatais

Contributions

Concept: HE, IH. Design: HE, FO, MI., Data collection: HE, IH, FO. Analysis or Interpretation: AA, HE, FO., Literature search: HE, IH., Writing: HE, IH, FO.

Publication History

Received: 16 May 2021

Accepted: 11 November 2021

Article published online:
09 February 2022

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