ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG CỦA U BUỒNG TRỨNG XOẮN Ở PHỤ NỮ CÓ THAI TẠI BỆNH VIỆN PHỤ SẢN TRUNG ƯƠNG

Abstract

Objective: To describe the clinical and paraclinical characteristics of ovarian torsion in pregnant women at the National hospital of Obstetrics and Gynecology. Subjects and Methods: A retrospective descriptive study was conducted on 73 medical records of pregnant women diagnosed with ovarian torsion after surgery at the National hospital of Obstetrics and Gynecology from January 1, 2019, to December 31, 2023. Results: The average age of participants is 30.8 ± 4.4 years. Ovarian torsion occurred in 50.7% of cases during pregnancies under 10 weeks, with the earliest case at 5 weeks. The incidence of ovarian torsion in primigravida is 57.7%. All pregnant women had abdominal pain, with severe abdominal pain reported in 69.9% of cases. Nausea and vomiting were observed in 57.2% of cases, most commonly in pregnancies under 10 weeks (57.1%). Blumberg sign was present in 50.7% of cases. The most ultrasound finding was an anechoic mass (61.6%). Right-sided ovarian torsion is more prevalent (63%). Torsion masses were most frequently 5–10 cm in size (64.4%). Absence of vascular signals on Doppler ultrasound was observed in 43.8% of cases. The time from symptom onset to hospital admission and the time from hospital admission to surgery were typically ≤24 hours in 83.6% and 79.5% of cases, respectively. Among patients tested for tumor markers, elevated levels of Ca-125, HE-4, and αFP were noted in 68.6%, 0%, and 50% of cases, respectively. Conclusion: Ovarian torsion in pregnant women predominantly occurs in the first trimester, with common symptoms including abdominal pain, nausea, vomiting, and abdominal wall reaction. Early detection and intervention are typical. Right-sided ovarian torsion is more frequent, and the condition is commonly associated with masses 5–10 cm in size. Ultrasound findings can assist doctors in early diagnosis of diseases; however, it need to be combined with clinical symptoms.