Anesthetic management of a patient with torsion of ovarian cyst in the third trimester of pregnancy

Nonobstetric surgeries during pregnancy are complicated by the need to balance the requirements of two lives—the mother and the fetus. Normally, surgeries during pregnancy are indicated only when it is absolutely necessary for the well-being of the mother, fetus, or both. The incidence of nonobstetric surgeries during pregnancy ranges between 0.75% and 2%. Torsion of ovary is one such nonobstetric emergency commonly seen in the third trimester. The ultimate goal is to provide safe anesthesia to the mother while simultaneously minimizing the risk of preterm labor or fetal demise. Given the general considerations of avoiding fetal exposure to polypharmacy and protection of maternal airway, regional anesthesia is usually preferred in pregnancy whenever appropriate. Here, we report a case of 23-year-old female parturient with 8 months of gestation, diagnosed as a case of torsion ovarian cyst, who was posted for emergency laparotomy, which was successfully managed with spinal anesthesia.