Ovarian Torsion During Pregnancy: Risks, Symptoms & Treatment

Ovarian torsion occurs when an ovary twists around the ligaments that support it. This twist restricts blood flow to the ovary and, in many cases, to the fallopian tube as well. Doctors also call this adnexal torsion.

When the blood supply drops, the ovary swells and begins to suffer from oxygen deprivation. Pain escalates quickly, and tissue damage can follow within hours. During pregnancy, hormonal changes and ovarian enlargement can increase the mobility of the ovary, which raises the risk of twisting.

Ovarian torsion usually develops when something makes the ovary heavier or more mobile than usual. Several ovarian torsion causes are well known in clinical practice:

• Ovarian cysts or masses, which shift the ovary’s balance.
• Enlarged ovaries are often linked to fertility treatments or early pregnancy.
• Ovarian torsion after egg retrieval occurs when the ovaries remain swollen after stimulation.
• Pregnancy-related hormonal changes loosen supporting ligaments.
• Anatomical factors, such as longer ovarian ligaments or prior torsion.

Ovarian torsion symptoms usually begin suddenly and intensify quickly. The most common signs are:

• Sharp, severe pain on one side of the lower abdomen or pelvis.
• Nausea, vomiting, or abdominal tenderness.
• Worsening pain with movements

During pregnancy, symptoms can overlap with other discomforts, which makes attention to pain intensity and sudden onset especially important.

Also Read – Pregnancy After Miscarriage: 6 Tips to Prepare for a Healthy Pregnancy

Diagnosing ovarian torsion depends on speed, clinical judgment, and imaging. Doctors start with a focused history followed by a physical examination to assess tenderness and exclude other causes of acute abdominal pain.

Blood tests may also be requested to support the evaluation, but they do not confirm torsion. Normal results do not exclude the condition.

Ultrasound for Ovarian Torsion

Ultrasound is the first-line imaging tool for suspected ovarian torsion. A transvaginal or abdominal scan helps visualize ovarian size, position, and structure. In many cases, the affected ovary appears enlarged or displaced.

Doppler ultrasound assesses blood flow. Reduced or absent flow raises concern, but normal flow does not rule out torsion. Intermittent twisting can preserve partial circulation early on, which is why imaging results must be interpreted alongside symptoms.

Additional Diagnostic Methods

When ultrasound findings remain unclear and pain persists, doctors may use further evaluation:

• MRI can provide additional detail without radiation exposure and is sometimes helpful during pregnancy.
• CT scans are less commonly used due to radiation concerns and limited added value for torsion.

Ovarian torsion requires urgent treatment because the ovary loses its blood supply as long as it stays twisted. Once doctors suspect torsion, the goal is to restore circulation as quickly as possible and prevent permanent damage. Treatment decisions depend on timing, ovarian condition, and whether you are pregnant.

Treatment for Ovarian Torsion Explained

Surgical intervention is the usual care for ovarian torsion. The doctors perform a minimally invasive surgery, typically a laparoscopy. The surgeon examines the ovarian tissue during surgery.

When the ovary appears viable, they save it and restore normal circulation. In most instances, once the ovary receives a blood supply, it will heal.

In case the torsion was due to an ovarian cyst or mass, the surgeon can cure it at the same time to minimize the chances of repetition. Timely treatment has a higher chance of preserving ovarian function and preventing long-term complications.

Treatment During Pregnancy

Ovarian torsion during pregnancy needs special attention. Surgeons do not postpone surgery.

Laparoscopy surgery is also applied in pregnancy and is considered to be safe. During abdominal procedures, surgeons change technique and positioning to prevent pressure on the uterus, particularly towards the end of the pregnancy.

Timely intervention in pregnancy usually delivers positive results. Most patients heal quickly, the pain resolves, and the pregnancy is not hindered.

You can minimize the risk of ovarian torsion by being vigilant for signs of growing ovaries. Here are some ways:

• Treatment of known ovarian cysts: If you were diagnosed with ovarian cysts, follow-up is important to monitor for size changes that can increase the risk of torsion.
• Act early on new symptoms: Sudden, one-sided pelvic pain should never be ignored, especially during pregnancy or fertility treatment cycles.
• Discuss prior torsion history: If you’ve had ovarian torsion before, inform your doctor. Recurrence is possible, and preventive strategies may be discussed.
• Observe imaging: Ultrasound is recommended to monitor ovarian enlargement and/or position changes and avoid complications.

Also Read – When Should You See A Fertility Specialist/Doctor?

Ovarian torsion is a rare but serious condition that demands immediate attention. During pregnancy, hormonal and anatomical changes increase ovarian mobility, which raises the risk even in otherwise healthy individuals. Diagnosis relies on symptoms, physical examination, and imaging, with ultrasound playing a central role.

If something feels wrong, trust that instinct. Sudden pelvic pain is never something to wait out. Acting quickly protects your health and, during pregnancy, supports the safest possible outcome for both you and your baby.