When an ovary bursts, a woman experiences severe pain and a number of other unpleasant symptoms. If you do not see a doctor in time, this phenomenon can lead to death. The doctor must refer the patient to an operation, with the favorable completion of which the possibility of pregnancy remains. The article will discuss the causes and consequences of ovarian rupture in women.
Classification
Depending on which signs of ovarian rupture are dominant, there are 3 varieties of this disease:
- anemic - the rupture is accompanied by profuse bleeding and is similar to the rupture of the fallopian tube during an ectopic pregnancy;
- pseudoappendicular - main symptoms: autonomic dysfunction and pain;
- mixed - combines the characteristics of the two above varieties.
According to the degree of development of pathology, they are distinguished:
- light form - with blood loss up to 150 ml;
- medium - 150-500ml;
- heavy - over 500 ml.
The most dangerous are anemic and mixed forms with the last degree of blood loss, as they lead to severe anemia.
Pseudoappendicular tear is one of the easiest. Usually, with this form, they do not resort to surgical intervention. A hematoma occurs in the tissues of the ovary, but there is no open hemorrhage into the pelvic cavity. The onset of the disease is characterized by a sharpness comparable to a knife blow. The pain gradually spreads to the entire lower abdomen, inner thigh, lower back.
The mixed form is mainly manifested first by pain, and then by bleeding. At the same time, unpleasant sensations become dull or disappear completely, as a result of which the woman postpones a visit to the doctor. This cannot be done. Immediately after the first signs of the disease, you need to visit a gynecologist.
Etiology
The causes and consequences of ovarian rupture will be discussed below.
In these organs, a mature woman grows follicles in which eggs mature. The beginning of a new menstrual cycle gives rise to the growth of a dominant follicle, reaching a size of about 20 mm by the middle of the cycle. During the normal course of this cycle, the follicular membrane ruptures with the release of the egg, which means the beginning of the ovulation process. In place of the ruptured follicle, a corpus luteum is formed, in which hormones are produced that prepare the female body for pregnancy.
In the case of sclerotic and dystrophic dynamics in the tissues of the ovaries, which develop under variousinflammatory processes and stimulation of ovulation with the help of drugs, disturbances occur in its process and the formation of the corpus luteum.
This results in:
- poorly reduced blood vessels at the site of rupture;
- a hematoma forms in the corpus luteum;
- increased intra-abdominal blood flow.
Also, the causes of ovarian rupture may be the following:
- inflammatory processes in the pelvic organs;
- hormonal disorders, including those caused by the withdrawal of contraceptives;
- formation of cysts on the corpus luteum or ovary - most often large cysts and tumors with a diameter of more than 50 mm rupture;
- blood clotting disorders due to various causes;
- excessive stress on the arteries during the onset of the menstrual cycle;
- frequent douching;
- pathologies inside blood vessels;
- formation of adhesive disease on the reproductive organs;
- strong physical activity;
- improper douching;
- excessive body weight, which provokes squeezing of blood vessels;
- visiting a sauna or bath;
- stormy intercourse;
- riding;
- abdominal injury;
- curvature of the uterus;
- retroflection;
- squeezing the ovary by a tumor of a nearby organ;
- sclerocystosis;
- ovarian varicose veins;
- rough gynecological examination;
- long-term use of anticoagulants.
Greatestthe number of cases of pathology is observed in women aged 25-30 years.
Symptoms of ovarian rupture
It is impossible to unambiguously determine by some specific signs that an ovary has burst. The main symptom of ovarian rupture is the appearance of severe pain in the lower abdomen, which gradually intensifies and begins to radiate to the groin and lower back.
Other possible symptoms:
- blood in vaginal discharge;
- reducing blood pressure;
- palpitations;
- frequent urge to urinate;
- with profuse internal bleeding - the appearance of cold sweat and blanching of the skin;
- nausea and vomiting;
- increase in temperature;
- disorientation;
- weakness;
- abdominal tension;
- dry mouth.
Symptoms of ovarian rupture in women depend on the etiology of the disease and the degree of its manifestation. When such an event occurs, a state of shock and fainting may occur. They occur in case of a severe form of pathology.
The most commonly diagnosed right-sided ovarian apoplexy (the scientific name of the disease). This is due to the fact that this organ receives the most blood supply and is located close to the aorta. Dominant follicles are formed in the majority of women in the right ovary.
Diagnosis
The causes and consequences of ovarian rupture are interrelated. The correct diagnosis of ovarian rupture isonly 4-5% of cases. This is due to the fact that the clinical picture is not characteristic and can develop like any other ailment characteristic of the small pelvis and abdominal cavity.
The patient is delivered to the hospital with a diagnosis of "acute abdomen". Clarification of the cause is made during hospitalization. Delaying a diagnosis can lead to increased blood loss and threaten a woman's he alth.
The diagnostic methods used are as follows:
- complaints of acute pain in the abdomen, which formed closer to the second part of the menstrual cycle;
- the affected ovary is painful, there are symptoms of peritoneal irritation;
- anemic and mixed forms are characterized by low levels of hemoglobin in the blood;
- the posterior fornix is punctured to detect intra-abdominal bleeding;
- ultrasound is performed, with the help of which a large corpus luteum is detected in the ovary with the presence of blood in it or in the abdomen, the gap itself is not determined;
- in case of a decision to operate for ovarian rupture, it is performed by laparoscopy, which allows you to establish the type of pathology with 100% certainty; if there is hemorrhagic shock or chronic adhesive process, then such a process is contraindicated, in this case, a therapeutic and diagnostic laparotomy is prescribed.
Palpation and examination on the gynecological chair reveal pain in the lower abdomen. When using a vaginal speculum, enlarged ovaries are detected,while the size of the uterus remains normal.
Thus, the final diagnosis is made at the time of the operation.
Conservative treatment
In order to prevent the negative consequences of ovarian rupture in a woman, the causes of this disease must be eliminated in time. Treatment can be carried out according to the principle of conservative therapy or surgery.
The first method can be used in case of small blood loss (up to 150 ml) for women who have passed the childbearing period or do not plan pregnancy in the future.
In this case, the following measures and drugs are prescribed:
- "Fenyuls", "Tardiferon" and other iron-containing products;
- "No-shpa", "Drotaverine", "Baralgin" and other antispasmodics and analgesics for the relief of pain;
- hemostatic pain relievers: vitamins B1, B6, B12, C, Vikasol, Etamzilat;
- rubber ice pack down the abdomen to provoke vasospasm, which will reduce pain by stopping bleeding;
- use of candles with belladonna;
- resolving therapy is used to prevent adhesions, anti-inflammatory drugs, enzyme preparations, vitreous bodies are used;
- strict bed rest.
Treatment of ovarian rupture is continued after symptom relief. The patient is prescribed electrophoresis with calcium chloride, treatment with Bernard currents, diathermy.
Conservative treatment in many cases leads to infertility, 50% of women who have undergone such therapy have relapses. This is due to the fact that blood and clots that are removed from the abdominal cavity during surgery, but remain in it, contributing to the formation of adhesions in the small pelvis.
Surgery
It is carried out to treat and prevent the causes and consequences of ovarian rupture. The operation is performed by laparoscopy or laparotomy with an advantage over the first method. His merits:
- small risk of adhesion formation with preservation of reproductive function;
- lower doses of pain medication after surgery;
- short hospital stay;
- quick recovery from anesthesia;
- women early activation;
- no gross scars in the abdomen.
Laparotomy is performed with adhesions, hemorrhagic shock, and also in the absence of the equipment necessary for the implementation of the first type of operation.
During the surgical intervention:
- blood stop;
- its removal with clots from the abdominal cavity;
- rinsing with antiseptic solutions.
With a large hemorrhage in the ovarian tissue, the latter can be completely removed.
Consequences
In most cases, the treatment prognosis is favorable.
Rupture of the ovaries in women can lead to very sadconsequences:
- malfunctions of the reproductive organs - more than 40% of women develop infertility due to chronic inflammatory processes, hormonal imbalance and adhesion formation, if one he althy ovary is left, the chances of pregnancy remain;
- peritonitis;
- ectopic pregnancy - formed due to torsion and bending of the fallopian tubes and the formation of adhesions in the pelvis, the possibility of its occurrence increases when one of the ovaries is removed;
- adhesion formation - observed with conservative therapy and delay with surgery, complications caused by its implementation, laparotomy, long-term surgery, chronic inflammation of the appendages;
- hemorrhagic shock;
- relapse of the disease - according to various sources, it can occur in 16-50% of cases, largely due to malfunctions in the endocrine system;
- fatal.
Thus, the consequences of ovarian rupture can be very negative for women's he alth, so you need to see a doctor in a timely manner.
Rehab
After the operation, the patient must undergo procedures that will allow her to restore her he alth.
In order to prevent the formation of adhesions, physiotherapy may be prescribed starting from 3-4 days after the operation:
- UHF;
- electrophoresis with hydrocortisone, lidase, zinc;
- low intensity laser therapy;
- electrical stimulation of the fallopian tubes;
- SMT;
- low frequency ultrasound.
To restore hormonal levels, patients need to take oral contraceptives in small doses for 1-3 months. Contraception after therapeutic treatment can be up to six months.
All women who have undergone an operation associated with the elimination of ovarian rupture, within one year after it, are subject to dispensary registration in the antenatal clinic. The initial examination is carried out a month after the surgical intervention, the subsequent - after 3 months and six months.
Before planning pregnancy, it is better for the patient to perform a diagnostic laparoscopy, during which the condition of the pelvic organs will be assessed. It should be planned if no abnormalities are found during this operation.
Prevention
As such, there are no special events of this kind. All women should visit a gynecologist regularly. He can tell if a particular woman's ovary will burst and when it might happen.
The fairer sex should not bother lifting weights, sports training should not be super intense. It is necessary to carry out the prevention of diseases of the genital organs, control the hormonal background, check the condition of the vessels. Sexual relations with a partner should be soft. After the operation, it is better to refuse sexual intercourse for 1-2 months.
If you have acute abdominal pain and doubts, you should consult a doctor. In order to make a correct diagnosis, in addition togynecologist, urologist and surgeon may be involved.
Occurrence of pathology during pregnancy
Due to hormonal changes in the body during this period, this phenomenon is rare. But when it occurs, as a rule, sparing therapy is carried out. Sometimes operations are performed that should not cause damage to the fetus. The most dangerous treatment is in the first trimester of pregnancy, as it can lead to spontaneous abortion.
Hormone therapy may be prescribed after surgery to increase the chance of pregnancy. A fertilized egg can be artificially introduced into the uterine cavity. In this case, damage to the ovary or even its absence will not affect the further course of pregnancy.
In conclusion
Rupture of the ovary can happen for various reasons, which can be both internal and external. This condition is very dangerous for a woman's he alth. It can provoke the appearance of various consequences, up to death. In order not to bring yourself to such a state, you need to listen to your body, not overwork, regularly undergo examinations by a gynecologist. Treatment can be carried out therapeutically and surgically. The first is used for mild forms of the disease and may be accompanied by numerous relapses. Therefore, laparoscopy is predominantly used. In severe forms of pathology and fainting, an abdominal operation is performed, as a result of which the abdominal cavity is freed from adhesions, accumulationsblood and clots. During the rehabilitation period, it is necessary to undergo various physiotherapy as prescribed by the doctor.
So, we have looked at the causes of ovarian rupture.
