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Ovarian apoplexy: symptoms, treatment and consequences

Apoplexy of the ovary poses a serious threat to the health and life of a woman. The prognosis is favorable only with timely assistance and no complications.

Content

Apoplexy of the ovary, what is it?

Apoplexy of the ovary is an acute gynecological disease, in which the rupture of blood vessels and ovarian tissue occurs. Urgent condition requires urgent medical attention, since hemorrhage into the abdominal cavity is fraught with large blood loss (up to 2 liters) and death.

Ovarian apoplexy

In the ovaries of women of reproductive age there are many vesicles filled with liquid - these are primordial follicles. Every month, one of them ripens an egg. It leaves the follicle (ovulates), in the place of which a yellow body is formed a little later. Without the onset of pregnancy, it lives no longer than two weeks, regresses, and menstruation begins.

During ovulation and development of the yellow body, and especially if these processes are violated (for example, a cyst is formed), the vessels of the ovarian tissue become weaker and easily damaged. This leads to hemorrhage.

The source of bleeding may be vessels of the primordial follicle, ovarian stroma, cyst - yellow body or follicular. First, the blood accumulates, forming a hematoma, and then poured into the abdominal cavity.

The disease is more often detected in girls and women 18-45 years, when the ovaries are actively functioning. If the rupture has already occurred, the risk of a re-hemorrhage is high enough.

Causes of apoplexy

Causes of apoplexy

Cases of apoplexy of the left or right ovary are more common in the second half of the cycle because the yellow body and ripe follicle are braided with a large number of blood vessels. Also, the cause of hemorrhage is seen in the action of the luteinizing hormone of the pituitary gland - it is actively produced during ovulation.

Internal factors:

  • Violation of the process of ovulation, when the egg leaves not only the wall of the follicle, but also the adjacent tissues of the ovary.
  • Vascularization of the yellow body (proliferation of additional vessels) or pathology in its development, for example, the formation of a cyst.
  • Abnormal location of the uterus.
  • Inflammatory process, when ovarian tissue becomes vulnerable.
  • A growing tumor of the uterus or neighboring organs that exerts pressure on the tissue.
  • Adhesive process in a small pelvis, for example, on the ovary after prolonged inflammation.
  • Bad coagulability of blood.
  • Pathologies of ovarian vessels - thinning, sclerosis, varicose veins.

External causes:

  • Increase in intra-abdominal pressure due to physical overstrain, sexual intercourse, lifting weights, riding.
  • Gynecological examination with a mirror, especially during the period of ovulation.
  • Injury of the abdominal cavity.
  • Reception of anticoagulants - drugs that dilute blood.

Apoplexy of the right ovary is diagnosed more often than the left one, since there are more blood vessels on this side and the blood supply comes from the central aorta.

Forms of pathology

The initial classification of ovarian apoplexy identifies three forms of the disease:

  1. Painful form - there are no signs of internal bleeding, but there is pain.
  2. Anemic, or hemorrhagic, - there are symptoms of intra-abdominal hemorrhage, pain syndrome may be absent.
  3. Mixed, which combines the two above mentioned species.

Modern physicians consider this division imprecise, since the rupture of the ovary is always accompanied by hemorrhage, and the condition is classified according to the severity level. The volume of blood loss determines the mild, moderate or severe form of apoplexy.

Symptoms of ovarian apoplexy

Symptoms of ovarian apoplexy

The main sign of apoplexy of the ovary is a sudden sharp pain in the abdomen caused by the flow of blood into the abdominal cavity and often radiating to the anus, the umbilical zone and the lower back. Bleeding, in addition to the pain syndrome, may be accompanied by other symptoms:

  • drop in blood pressure;
  • dizziness and weakness;
  • increased heart rate;
  • increased temperature and chills;
  • dry mouth;
  • vomiting, nausea;
  • short-term loss of consciousness with slowing of the pulse and blanching of the skin.

With apoplexy, intermenstrual blood discharges from the vagina and frequent urination (up to 10 or more times a day) can be observed.

Diagnostics

After studying complaints, medical history (determining the phase of the menstrual cycle, the presence of accompanying pathologies) and examining the woman, diagnostic tests are carried out:

  • The ultrasound shows the presence of fluid in the abdominal cavity.
  • A general blood test reveals a decrease in the level of hemoglobin, and with inflammation and an increase in leukocytes.
  • Puncture of the abdominal cavity from the side of the vagina, performed under general anesthesia.
  • Laparoscopy - is simultaneously a method of diagnosis and surgical treatment.

Treatment of ovarian apoplexy

With apoplexy of the ovary, surgery is the optimal method of therapy, but some patients with mild pathology refuse to perform it.

But conservative therapy is not always effective and is recommended only for women who already have children and are not going to give birth anymore.

If pregnancy is planned, then laparoscopy is the main therapeutic measure. During the operation coagulation of the rupture or suturing of the ovary is carried out, and in the case of the cyst - its removal.

Contraindications to laparoscopy: critical hemorrhage with syncope (hemorrhagic shock), impaired blood clotting, cardiovascular pathology, bronchial asthma , severe exhaustion.

Conservative treatment is carried out in a hospital under the constant supervision of medical staff and includes:

  • a state of complete rest;
  • the imposition of cold on the lower abdomen to narrow the vessels and reduce pain;
  • drugs to eliminate spasms (Papaverin, Drotaverin, No-shpa);
  • reception gemostatikov - hemostatic means (Traneksam, Etamsilat, Amben);
  • physiotherapy - electrophoresis, microwave therapy;
  • vitamin therapy (B1, B12, B6).

Repetition of a pain attack is regarded as an indication for surgical treatment.

Pregnancy after apoplexy

Pregnancy after apoplexy

As a result of surgical treatment, the ovary retains the ability to produce eggs, since only part of it is removed with laparoscopy. Therefore, with timely assistance provided after ovarian apoplexy, you can get pregnant.

This also applies to the complete removal of the organ - in the absence of complications, the ovum will still ripen on the other side, and the possibility of conception persists.

Problems arise if adhesions form in the abdominal cavity. With ovarian apoplexy transferred, the consequences after the operation can be minimized, following all the instructions of the attending physician.

The recovery period includes:

  • anti-inflammatory antibiotic therapy;
  • physiotherapeutic procedures;
  • use of reliable contraceptives within half a year after laparoscopy.

The risk of developing the adhesion process reduces the intake of hormonal drugs (Yarina, Regulon, Novinet and others).

Prevention

Ovarian tissue after apoplexy is subject to repeated development of the disease, so preventive measures are important. At the expressed hormonal disbalance and infringements in work of the central nervous system appearing after an anemic form of a pathology, are appointed:

  • means for improving cerebral circulation;
  • nootropic medicines;
  • hormonal contraceptives;
  • diuretic if intracranial pressure is increased.

For all women, it is necessary to exclude provoking factors - inflammation of the appendages and other diseases of the pelvic organs, physical overstrain. It is especially important to take care of yourself in the second half of the cycle - during the period of ovulation, before and during menstruation.

Interesting

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