ADNEXAL TORSION AND PREGNANCY: A CASE REPORT AND REVIEW OF THE LITERATURE

Adnexal torsion during pregnancy is a rare but critical surgical emergency, particularly challenging when it occurs on the left side. Its non-specific presentation can delay diagnosis and jeopardize both ovarian function and pregnancy viability. Although prompt surgical intervention is crucial, conservative approaches are increasingly favored to preserve fertility and hormonal function. This report describes a rare case of left ovarian torsion in a 23-year-old primigravida at 7 weeks of gestation, caused by a large serous cystadenoma. Diagnosis was confirmed by ultrasound and MRI, and urgent laparotomy revealed a viable ovary despite torsion. The patient underwent detorsion, cystectomy, and ovariopexy, followed by vaginal progesterone supplementation for luteal support. Pregnancy progressed uneventfully to term with the birth of a healthy infant. This case highlights the value of conservative surgical management, the importance of timely imaging, and the potential role of adjunctive progesterone therapy. Further studies are needed to optimize the diagnosis, management, and long term outcomes of adnexal torsion in pregnancy.