A patient at 5 months pregnancy complains of acute lower abdomen pain. On examination cervical os is closed and there is a tender right adnexal mass. On USG there is a normal intrauterine pregnancy with a 6 cm right ovarian dermoid cyst. Most probable diagnosis is?

Ovarian masses in pregnancy may be symptomatic or incidentally detected on USG. Here since the ovarian mass is extremely tender, it has probably undergone torsion and a Doppler should be done to diagnose torsion followed by an urgent cystectomy Complications of ovarian masses in pregnancy Rupture Torsion Hemorrhage Obstruction in labour Management <5 cm: follow up 5-10 cm: cystectomy in case of torsion, rupture, suspicion of malignancy, sudden increase in size during follow up >10 cm: elective cystectomy in second trimester NOTE: red degeneration is a complication of fibroid in pregnancy Since cervical os is closed, it is not a case of inevitable aboion