Could sudden pregnancy pain be ovarian torsion?

What does the evidence show for ovarian torsion?

• Twisting can obstruct drainage and eventually damage ovarian tissue. It can involve an enlarged ovary or mass, but it also occurs in an ovary without a known cyst. The possibility is assessed from symptoms, examination and imaging together. 1
• Pregnancy and enlarged ovaries after fertility stimulation are relevant clinical context. Tell the emergency team about recent fertility care and any scan showing an ovarian mass. A risk factor increases concern but cannot establish the cause of pain by itself. 2
• Doppler ultrasound may still show flow when torsion is present because ovarian blood supply and the degree of twisting vary. Persistent clinical concern should not be dismissed solely because a report mentions blood flow. Specialists interpret the overall findings. 1
• Ectopic pregnancy can also produce one-sided pain, bleeding, shoulder pain or faintness, particularly early in pregnancy. Distinguishing these emergencies requires clinical evaluation. Do not choose between them using a symptom checklist or wait for all possible symptoms to appear. 3
• Severe pain that starts suddenly or continues is a reason to seek immediate care during pregnancy. If you feel faint or unstable, use emergency services rather than driving yourself. Mention the pregnancy even when pain seems to be centered around an ovary. 4

When should I call my provider about ovarian torsion?

Get emergency assessment now for sudden severe pelvic or abdominal pain, especially with vomiting, faintness or bleeding. Call emergency services if you feel unstable. Do not wait for a routine prenatal appointment or for every symptom listed here.