Clinical Characteristics and Obstetric Outcomes of Pregnant Women Who Underwent Surgery for Adnexal Torsion

ZHU Cai-xia; CAI Shi-qin; HUANG Xiao-qing; WANG Dong-yu

doi:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0621

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Clinical Characteristics and Obstetric Outcomes of Pregnant Women Who Underwent Surgery for Adnexal Torsion

Clinical Research | 更新时间：2024-02-19

- Clinical Characteristics and Obstetric Outcomes of Pregnant Women Who Underwent Surgery for Adnexal Torsion
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 44, Issue 6, Pages: 1053-1059(2023)
- 作者机构：
  
  中山大学附属第一医院妇产科，广东广州 510080
- 作者简介：
  
  WANG Dong-yu； E-mail： wangdy28@mail.sysu.edu.cn
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0621
  CLC： R714.7
- Published：20 November 2023，
  
  Received：09 May 2023，
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祝彩霞,蔡诗琴,黄晓晴等.妊娠期附件扭转手术治疗病例临床特点及妊娠结局分析[J].中山大学学报（医学科学版）,2023,44(06):1053-1059.

ZHU Cai-xia,CAI Shi-qin,HUANG Xiao-qing,et al.Clinical Characteristics and Obstetric Outcomes of Pregnant Women Who Underwent Surgery for Adnexal Torsion[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(06):1053-1059.
祝彩霞,蔡诗琴,黄晓晴等.妊娠期附件扭转手术治疗病例临床特点及妊娠结局分析[J].中山大学学报（医学科学版）,2023,44(06):1053-1059. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0621.

ZHU Cai-xia,CAI Shi-qin,HUANG Xiao-qing,et al.Clinical Characteristics and Obstetric Outcomes of Pregnant Women Who Underwent Surgery for Adnexal Torsion[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(06):1053-1059. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0621.

摘要

目的

探讨手术治疗的不同孕周的妊娠期附件扭转的临床特点和妊娠结局。

方法

回顾性分析2013年3月至2023年3月在中山大学附属第一医院住院手术治疗并分娩的39例妊娠期附件扭转患者的临床资料，其中妊娠早期（

14周）18例，妊娠中期（14~27

周）11例，和妊娠晚期（≥28周）10例，比较3组的临床特点、诊治和妊娠结局的差异。

结果

妊娠早期组辅助生殖技术受孕的比例高于妊娠中、晚期组（

=0.026）。3组患者腹痛、恶心、呕吐、发热等临床表现差异无统计学意义，但妊娠中、晚期组患者白细胞升高更常见。妊娠早、中、晚期发生扭转的直径

5 cm的附件包块分别占0.0%、18.2%和10.0%，具有统计学差异（

=0.014）。但扭转的附件位置、圈数、病理性质均差异无统计学意义。超声对于妊娠早期附件扭转的诊出率显著高于妊娠中、晚期组（77.8%，36.4%， 20.0%；

=0.008）。妊娠早期组选用腹腔镜手术比例高于妊娠中、晚期组（55.6% ， 27.3%， 0.0%；

=0.008）。3患者的分娩孕周、分娩方式、新生儿性别、新生儿出生体质量和随访情况均差异无统计学意义，但妊娠晚期组早产风险高于妊娠早、中期组（

=0.050）。

结论

辅助生殖技术受孕更常见于妊娠早期组附件扭转患者，当同时出现腹痛、白细胞升高且无感染征象时，需要警惕附件扭转，超声在妊娠早期附件扭转的诊断价值高，妊娠期附件扭转腹腔镜手术安全，母儿预后良好。

Abstract

Objective

To explore the clinical characteristics and obstetric outcomes of pregnant women who underwent surgery for adnexal torsion at different gestational weeks.

Methods

A retrospective study was done on 39 women who underwent surgery for adnexal torsion during pregnancy in the First Affiliated Hospital， Sun Yat-sen University between March 2013 and March 2023， with 18 cases in 1

trimester （

14 weeks）， 11 in 2

trimester （14-27

weeks） and 10 in 3

trimester （≥28 weeks）. The clinical characteristics， treatment and obstetric outcomes were compared among the three groups.

Results

The 1

trimester group had higher proportion of assisted reproductive technology （ART） use than the 2

and 3

trimester groups （

=0.026）. There was no significant difference in the clinical manifestations， including abdominal pain， nausea， vomiting and fever among the three groups， while elevated white blood cells （WBC） counts was more commonly seen in the 2

and 3

trimester groups. Adnexal masses

5 cm in diameter occurred in 0， 18.2%， and 10.0% of cases in 1

， 2

and 3

trimester groups respectively （

=0.014）. No statistical significance was found in the location of twisted adnexa， number of circles or pathological nature. The 1

trimester group had a higher sensitivity of ultrasound in the diagnosis of adnexal torsion compared with the 2

and 3

trimester groups （77.8%， 36.4%， 20.0%；

=0.008）. More laparoscopic surgery were performed in the 1

trimester group than the other two groups （55.6% ， 27.3%， 0.0%；

=0.008）. There was no significant difference in gestational week of delivery， delivery mode， newborn gender， neonatal birth weight and follow-up of newborns among the three groups. The 3

trimester group showed a higher risk of preterm delivery （

=0.050）.

Conclusions

During the 1

trimester of pregnancy， adnexal torsion is more common in patients using ART and ultrasound plays a crucial role in the diagnosis. During the 2

and 3

trimester， adnexal torsion should be suspected in patients with abdominal pain and elevated WBC but no aspetic inflammation. Laparoscopic surgery is safe for adnexal torsion during pregnancy and can achieve a favorable maternal and neonatal outcome.

关键词

附件扭转孕周临床特点妊娠结局腹痛白细胞升高

Keywords

adnexal torsiongestational weekclinical characteristicsobstetric outcomesabdominal painelevated WBC

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Related Institution

The First Affiliated Hospital，Sun Yat-sen University

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