Management of a 5 cm dermoid cyst which has undergone torsion at 10 weeks of pregnancy is:
**Core Concept**
A dermoid cyst, also known as a mature cystic teratoma, is a type of ovarian tumor that can cause torsion, especially during pregnancy. Torsion occurs when the ovary twists around its stalk, cutting off blood supply to the ovary and the surrounding tissue. The management of a dermoid cyst that has undergone torsion during pregnancy is crucial to prevent ovarian necrosis and preserve fertility.
**Why the Correct Answer is Right**
In a pregnant woman, the management of a dermoid cyst that has undergone torsion is more complex due to the risk of ovarian necrosis and the potential for malignancy. The correct approach is to perform an emergency laparoscopy or laparotomy to untwist the ovary and resect the dermoid cyst. This method allows for the preservation of the ovary and the surrounding tissue, minimizing the risk of ovarian necrosis and preserving fertility.
* **Option A:** Immediate cesarean section is not the correct initial approach as it does not address the torsion and potential ovarian necrosis.
* **Option B:** Expectant management is not suitable for a dermoid cyst that has undergone torsion, as it can lead to ovarian necrosis and permanent damage.
* **Option C:** The management of a dermoid cyst that has undergone torsion during pregnancy requires surgical intervention, but this option does not specify the type of surgery.
**Clinical Pearl / High-Yield Fact**
In pregnant women, dermoid cysts are more likely to cause torsion due to the increasing size of the uterus, which can lead to ovarian torsion. Early recognition and prompt surgical intervention are crucial to prevent ovarian necrosis and preserve fertility.
**Correct Answer: C. Emergency laparoscopy or laparotomy to untwist the ovary and resect the dermoid cyst.**