Ovarian rupture: symptoms and consequences

When the woman’s ovary burst, severe pain and a number of other unpleasant symptoms occur. If you do not consult a doctor in time, this phenomenon can be fatal. The doctor should direct the patient to an operation, with a favorable completion of which the possibility of pregnancy remains. The article will examine the causes and consequences of ovarian rupture in women.

Classification

Depending on which signs of ovarian rupture are dominant, 3 types of this disease are distinguished:

• anemic - a rupture accompanied by profuse bleeding and is similar to a rupture of the fallopian tube during an ectopic pregnancy;
• pseudoappendicular - the main symptoms: autonomic dysfunction and pain;
• mixed - combines the characteristics of the two above varieties.

According to the degree of development of pathology, they distinguish:

• mild form - with blood loss up to 150 ml;
• average - 150-500 ml;
• heavy - over 500 ml.

The most dangerous anemic and mixed forms with the last degree of blood loss, since they lead to severe anemia.

Pseudoappendicular rupture 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 in the pelvic cavity. The onset of the disease is characterized by a sharpness comparable to that of a knife. The pain gradually passes to the entire lower abdomen, the inner surface of the thigh, lower back.

The mixed form is mainly manifested first by pain, and then by bleeding. In this case, the unpleasant sensations become dull or go away completely, as a result of which the woman postpones the 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 has follicles in which the eggs mature. The beginning of a new menstrual cycle causes the growth of a dominant follicle, reaching a value of the order of 20 mm by the middle of the cycle. In the normal course of this cycle, the follicular membrane breaks with the release of the egg, which means the beginning of the ovulation process. A yellow body forms at the site of the torn follicle, 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 during various inflammatory processes and stimulate ovulation with the help of drugs, disturbances arise in its process and the formation of the corpus luteum.

This leads to:

• blood vessels at the rupture site are poorly contracted;
• a hematoma forms in the corpus luteum;
• increased abdominal blood flow.

The causes of ovarian rupture can also be the following:

• inflammatory processes in the pelvic organs;
• hormonal disorders, including those caused by the abolition of contraceptives;
• the formation of cysts on the corpus luteum or ovary - most often large cysts and tumors with a diameter of more than 50 mm rupture;
• bleeding disorders due to various reasons;
• excessive load on the arteries during the onset of the menstrual cycle;
• frequent douching;
• pathology inside the blood vessels;
• the formation of adhesive disease on the reproductive organs;
• strong physical activity;
• improper douching;
• excess body weight, which provokes squeezing of blood vessels;
• visit to the sauna or bath;
• violent coitus;
• horseback riding;
• trauma to the abdomen;
• bend of the uterus;
• retroflexion;
• squeezing the ovary with a tumor of a nearby organ;
• sclerocystosis;
• varicose ovarian veins;
• rough examination by a gynecologist;
• taking anticoagulants for a long time.

The greatest number of cases of pathology is observed in women aged 25-30 years.

Symptoms of ovarian rupture

It is impossible to clearly determine by any specific signs that the 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 give to the groin and lower back.

Other possible symptoms:

• the appearance of blood in the discharge from the vagina;
• lowering blood pressure;
• cardiopalmus;
• frequent urination;
• with profuse internal bleeding - the appearance of cold sweat and blanching of the skin;
• nausea and vomiting;
• temperature increase;
• disorientation of orientation;
• weakness;
• tension of the abdominal muscles;
• dry mouth.

Symptoms of ovarian rupture in women depend on the etiology of the disease and the degree of its manifestation. In the event of a similar event, a shock state and fainting may occur. They occur in the case of a severe form of pathology.

The most commonly diagnosed right-sided ovarian apoplexy (the scientific name for the disease). This is due to the fact that this organ receives the greatest blood supply and is located close to the aorta. Dominant follicles are formed in the majority of women in the right ovary.

Diagnostics

The causes and consequences of ovarian rupture are interrelated. The correct diagnosis of ovarian rupture is only 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. Slowing down the diagnosis can lead to increased blood loss and threaten the health of a woman.

The diagnostic methods used are as follows:

• complaints of acute abdominal pain that formed closer to the second part of the menstrual cycle;
• the affected ovary is marked by soreness, there are symptoms of peritoneal irritation;
• anemic and mixed forms are characterized by a reduced level of hemoglobin in the blood;
• puncture of the posterior arch to detect intra-abdominal bleeding;
• an ultrasound is performed, with the help of which a large yellow body with the presence of blood in it or in the abdomen is detected in the ovary, the gap itself is not determined;
• in the case of a decision on surgery for ovarian rupture, it is performed by laparoscopy, which allows you to establish the type of pathology with 100% certainty; if there is a hemorrhagic shock or chronic adhesive process, then a similar process is contraindicated, in this case, a therapeutic and diagnostic laparotomy is prescribed.

Palpation and examination on a gynecological chair can reveal pain on the side of the lower abdomen. When using a vaginal mirror, increased ovarian size is detected, despite the fact that the size of the uterus remains normal.

Thus, the final diagnosis is made during the operation.

Conservative treatment

In order to prevent the negative consequences of an ovarian rupture in a woman, the causes of this disease must be eliminated in time. Treatment can be carried out on the basis of conservative therapy or surgical intervention.

The first method can be used in case of slight blood loss (up to 150 ml) for women who have passed the period of childbearing or are not planning a pregnancy in the future.

In this case, the following activities and drugs are prescribed:

• Fenyuls, Tardiferon and other iron-containing products;
• “No-shpa”, “Drotaverin”, “Baralgin” and other antispasmodics and analgesics for the relief of pain;
• hemostatic agents to reduce pain: vitamins B ₁ , B ₆ , B ₁₂ , C, Vikasol, Etamzilat;
• a rubber hot-water bottle with ice down the abdomen to provoke vasospasm, which will reduce pain by stopping bleeding;
• the use of candles with beladonna;
• absorbable therapy is used to prevent adhesions, anti-inflammatory drugs, enzyme preparations, vitreous bodies are used;
• strict bed rest.

Treatment for ovarian rupture is continued after symptoms are reduced. The patient is prescribed electrophoresis with calcium chloride, treatment with Bernard currents, diathermy.

Conservative treatment in many cases leads to infertility, and 50% of women who have undergone such therapy have relapses. This is due to the fact that blood and clots, which during surgery are removed from the abdominal cavity, but remain in it, contributing to the formation of adhesions in the small pelvis.

Surgical intervention

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. Its advantages:

• low risk of adhesions with reproductive function;
• lower doses of painkillers after surgery;
• short term in hospital;
• quick exit from anesthesia;
• early activation of a woman;
• no gross abdominal scars.

Laparotomy is performed with an adhesive process, hemorrhagic shock, and also in the absence of equipment necessary for the first type of operation.

In the process of surgery is performed:

• blood stop;
• its removal with clots from the abdominal cavity;
• washing with antiseptic solutions.

With a large hemorrhage in the ovarian tissue, the latter can be completely removed.

Effects

In most cases, the prognosis of treatment is favorable.

Ovarian rupture in women can lead to very sad consequences:

• malfunctions of the reproductive organs - more than 40% of women develop infertility due to chronic inflammatory processes, hormonal imbalance and the formation of adhesions, in the case of leaving one healthy ovary, the chances of pregnancy remain;
• peritonitis;
• ectopic pregnancy - formed due to torsion and kink of the fallopian tubes and the formation of adhesions in the pelvis, the possibility of its appearance increases with the removal of one of the ovaries;
• the formation of adhesions - observed with conservative therapy and delayed operation, the complications caused by its implementation, the implementation of laparotomy, prolonged 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 of the endocrine system;
• fatal outcome.

Thus, the consequences of ovarian rupture can be very negative for women's health, so you need to see a doctor in a timely manner.

Rehabilitation

After the operation, the patient must undergo procedures that will allow her to restore health.

In order to prevent the formation of adhesions, physiotherapy can 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 the hormonal background, 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 underwent surgery associated with the elimination of ovarian rupture, within one year after it, are subject to medical examination in the antenatal clinic. The initial examination is carried out a month after the surgical intervention, the subsequent ones - after 3 months and half a year.

Before planning pregnancy, the patient is better to perform diagnostic laparoscopy, during which the state of the pelvic organs will be evaluated. It should be planned if during this operation no pathologies are detected.

Prevention

As such, special events of this kind are not provided. All women should visit a gynecologist regularly. He can tell if a particular woman’s ovary will burst and when it can 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 state of the vessels. Sexual relationships with a partner should be soft. After the operation, for 1-2 months it is better to abandon sexual intercourse.

In the presence of acute abdominal pain and doubt, consult a doctor. In addition to the gynecologist, a urologist and surgeon can be involved in making the correct diagnosis.

The 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 they also carry out operations that should not cause damage to the fetus. The most dangerous treatment in the first trimester of pregnancy, as it can lead to spontaneous abortion.

To increase the chance of pregnancy after surgery, hormone therapy may be prescribed. A fertilized egg can artificially invade the uterine cavity. In this case, damage to the ovary or even its absence will not affect the further course of pregnancy.

Finally

Ovarian rupture can occur for various reasons, which can be either internal or external in nature. This condition is very dangerous for a woman’s health. It can provoke the appearance of various consequences, up to a fatal outcome. In order not to bring yourself to such a state, you need to listen to your body, not to overwork, regularly undergo examinations by a gynecologist. Treatment can be therapeutically and surgically. The first is used for mild forms of the disease and can be accompanied by numerous relapses. Therefore, laparoscopy is predominantly used. In severe forms of pathology and fainting, a cavity operation is performed, as a result of which the abdominal cavity is freed from adhesions, accumulations of blood and clots. During the rehabilitation period, it is necessary to undergo various physiotherapy procedures as prescribed by the doctor.

So, we examined the causes of ovarian rupture.