Category: Obstetrics & Gynecology
Posted: 8/11/2025 by Jennifer Wang, MD
(Updated: 12/5/2025)
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Pain, bleeding, fever - what symptoms actually mean something when it comes to ovarian torsion?
Well, in this retrospective case-control study looking at 221 patients from 2011 to 2022, Aiob et. al looked at a ton of history, physical exam, and ultrasound findings to see which ones correlated most strongly with ovarian torsion. They found that vomiting and reports of localized pain (v diffuse pain) were highly associated with surgery-confirmed ovarian torsion. In multivariate analysis, localized pain had an odds ratio of 4.36 and vomiting had an odds ratio of 2.38.
Additionally, on ultrasound findings, ovarian edema was much more likely to be present in torsion cases, with an odds ratio of 5.29.
This is a retrospective single center study that comes with all the limitations that these studies always come with, but let this be a reminder of what should trigger your Spidey-senses!
Additional note: We all know that torsion is a diagnosis that can only be confirmed by surgery, no matter what Doppler flow looks like, and this study just adds onto that pile of evidence: Doppler flow was not significantly different between patients who ended up having torsion and those who didn't. >60% of patients who ended up having torsion had normal flow, so like always, remember that a normal Doppler does not exclude torsion in a patient who you're worried about! Talk to OBGYN!
Aiob A, Shushan Marom SB, Gumin D, Lowenstein L, Sharon A. Identifying reliable predictors of ovarian torsion in acute gynecological presentations: A retrospective case-control study. Eur J Obstet Gynecol Reprod Biol. Published online August 6, 2025. doi:10.1016/j.ejogrb.2025.114627
