58 Introduction Acute abdomen during third trimester of pregnancy presents as an obstetrical emergency and is usually diagnosed as a case of ovarian torsion or appendicitis. But the finding of twisted fallopian tube at laparotomy comes as a surprise, as the condition is uncommon though 12% cases are associated with pregnancy with the reported incidence of 1in 1,500,000 women. 1,2 In this context we are going to describe a pregnancy that continued to term resulting in a live birth after resection of a fallopian tube that had undergone torsion (unilateral salphingectomy) at 32 weeks pregnancy in a primigravida; despite postoperative morbidity consistent with abdominal wound infection leading to gaped wound needing resuture. Case A 24 year pregnant primigravida at 32 weeks presented with acute right sided lower abdomen pain. Clinically she was afebrile but tachycardia, dehydrated with normal blood pressure recording. Uterus corresponded to gestational age and fetal heart rate was regular. A diagnosis of urinary tract infection or twisted ovarian cyst was made. Preliminary urinary microscopic examination was normal and so were CBC, serum Unilateral torsion of fallopian tube at 32 of weeks of pregnancy followed by a normal delivery Indira Upadhyaya, Richa Sharma Paropakar Maternity and Women’s Hospital Correspondence Indira Upadhyaya MD, Obstetrician / Gynaecologist Paropakar Maternity and Women’s Hospital Thapathali, Kathmandu Mobile: 9851074598 Abstract A 24 year primi gravida at 32 weeks pregnancy presented with acute abdomen simulating torted ovarian tumor that underwent laparatomy/unilateral salpingectomy with the diagnosis of fallopian tube torsion is presented because of uneventful term vaginal delivery despite postoperative complication like gaped abdominal wound needing secondary suture. Keywords eywords eywords eywords eywords: acute abdomen in pregnancy, acute abdomen due to fallopian tube torsion. biochemistry. In the next 24 hours, pain lower abdomen went on increasing without any drastic change in vital signs and there was no nausea or vomiting. However, generalized abdominal tenderness and guarding was observed in the right iliac fossae. Therefore USG abdomen was done that showed a singleton live baby at 32 weeks with normal liquor. An adnexal mass measuring 80×60mm was seen giving a suspicion of ovarian mass. Right renal pelvicalceal dilation was also noted. Making a diagnosis of right ovarian cyst torsion in pregnancy, emergency laparotomy was done. On the contrary, huge hydrosalpinx of the right tube was visualized which had undergone torsion twice on its axis with small fimbrial cyst. So partial right salpingectomy was performed. Left tube and ovaries were normal. Intra operative period was covered with i/ m inj. terbutalin 0.5 mg to prevent premature uterine contraction and the latter was repeated six hours post operation. The post operative period was complicated by gaping of the abdominal wound needing the application of secondary suture. She was discharge on 16th day of surgery after the removal of sutures. Fortunately, her pregnancy advanced smoothly ending in a spontaneous vaginal delivery of alive male baby at 38 weeks period of gestation. Her postnatal period was uneventful. NJOG 2009 June-July; 4 (1): 58-59