FV Hospital recently treated a pregnant woman suffering from severe abdominal pain caused by ovarian torsion, posing a risk of ovarian necrosis and miscarriage.

Doctors from the Obstetrics & Gynaecology Department – Breast Care Clinic performed laparoscopic surgery to untwist the ovary, successfully preserving the mother’s ovary and baby’s life.

A pregnant woman was urgently treated for severe abdominal pain, which was diagnosed as ovarian torsion.

At 8 weeks pregnant, Ms. D.T.H.T., 31 years old from District 12, Ho Chi Minh City, suddenly experienced severe pelvic pain and was rushed to FV Hospital by her family for emergency treatment. Following a thorough examination and testing over approximately two hours, she was transferred to the Obstetrics & Gynaecology Department – Breast Care Clinic for specialized care.

Upon examining the patient and reviewing her symptoms and imaging results, Dr Nguyen Duc Truong from the Obstetrics & Gynaecology Department – Breast Care Clinic diagnosed her with ovarian torsion.

Ovarian torsion is a gynaecological emergency that occurs when an ovary twists around the ligaments holding it in place. This condition is rare in pregnant women, occurring in only 1.6 per 10,000 cases. During pregnancy, the ovary can enlarge, and hormones may cause water retention and swelling, making the supporting tissues of the ovary looser and more susceptible to twisting.

“Pregnant women with ovarian torsion are at risk of miscarriage. If not detected in time, the ovary may suffer necrosis, reducing the chances of future pregnancies,” Dr Truong explained.

Emergency Surgery Guided by Professional Expertise.

When Ms T. was brought in for emergency care, she was given pain relief and then transferred to the Obstetrics Department for observation. Although her pain had subsided, Dr Truong still considered whether surgery was necessary for her condition.

According to Dr Truong’s analysis, the reduction in pain could have been due to the pain medication or the possibility that the ovary had spontaneously untwisted. If surgery were performed at that time, it would be an unnecessary intervention, posing potential risks to both the mother and the baby. On the other hand, when ovarian torsion first occurs, the patient experiences severe pain, but over time, they may become “numb” and feel little to no pain. In this case, if the doctor does not intervene, the pregnant woman risks ovarian necrosis, which could affect her fertility. The necrotic mass may form a clot, increasing the risk of miscarriage. However, there is no clear medical evidence to determine how long ovarian torsion must last before necrosis occurs.

“Ultrasound only provides supportive information, indicating whether the ovary is twisted, but the challenge lies in determining the right time for intervention. At this point, the doctor must rely on instinct and professional experience,” Dr Truong explained, adding that at that moment, his strongly felt that the surgery was necessary.

However, performing surgery on a pregnant woman is highly challenging, as it requires minimising medication use and completing the procedure as quickly as possible. The longer the surgery takes, the greater the risk to the baby.

“Furthermore, surgery on a pregnant woman carries a higher risk of bleeding and complications, due to the softer tissues that are more susceptible to injury and increased blood vessel growth. The untwisting procedure must be performed with great care. Additionally, a pregnant woman’s weakened immune system increases the risk of infection,” Dr Truong observed.

The laparoscopic surgery, led by Dr Nguyen Duc Truong, was performed urgently with the utmost caution. The doctor accessed the ovary through incisions at the navel and abdomen, measuring 5 mm and 1 cm, respectively. At this point, the ovary had twisted like a rope, compressing the blood vessels and causing bruising. After assessing that the ovary’s function remained intact, the surgical team promptly untwisted it for the patient.

The untwisting procedure lasted approximately 30 minutes, with the actual intervention taking less than 10 minutes. Two days after surgery, an ultrasound confirmed that blood flow had returned to the ovary. The patient was discharged two days later.

A follow-up one week later confirmed that the blood vessels were recovering well, the ovary had nearly returned to normal, and the foetus was developing healthily. The patient’s family was overjoyed and deeply grateful for the decisive decision made by the doctor.

Ovarian torsion symptoms can easily be mistaken for kidney or digestive issues. Therefore, Dr Truong advises women experiencing lower abdominal pain to seek immediate medical attention. Pregnant patients should avoid any physical manipulation, including taking painkillers. Upon arrival at the hospital, an ultrasound will be performed to accurately diagnose the cause and determine the appropriate treatment.

For more information about ovarian torsion, please contact the Obstetrics & Gynaecology Department – Breast Care Clinic at 028 5411 3333 or visit 6 Nguyen Luong Bang, District 7, Ho Chi Minh City.