Ovarian apoplexy is a sudden rupture of the ovarian capsule (left or right), accompanied by hemorrhage into its cavity.
Pathology exists in two forms:
- without bleeding into the abdominal cavity,
- with intra-abdominal bleeding.
Apoplexy of the right ovary is more common. The disease is possible at any age, but most often occurs during the reproductive period.
The cause is most often inflammatory diseases of the internal genital organs of a woman, which lead to disorders of the ovarian vessels (varicose dilatation, sclerosis or thinning of the walls of blood vessels).
These disorders prevent the blood from circulating normally, therefore, the ovarian capsule ruptures and bleeding into the abdominal cavity begins.
Ovarian apoplexy can also be provoked by:
- ovulation (the release of a mature egg into the abdominal cavity);
- too violent intercourse in the middle of the menstrual cycle;
- careless lifting of weights;
- abdominal trauma.
Most often, ovarian apoplexy occurs in the middle of the menstrual cycle (approximately 12-15 days), or in the second half of the cycle.
A woman suddenly feels a sharp pain in the area of the right or left ovary, radiating into the anus, external genitals, lumbar region or leg on the affected side.
In the presence of intra-abdominal bleeding, the following are observed:
- a sharp decrease in pressure,
- rapid pulse,
- pallor of the skin.
Sometimes the pain is so severe that it leads to cardiovascular failure.
If you suspect ovarian apoplexy, you must immediately take a horizontal position and urgently call an ambulance for hospitalization in a surgical or gynecological hospital.
Before the arrival of the doctor, in no case should you take any painkillers, it is forbidden to apply ice or a heating pad with warm water on the lower abdomen.
Diagnosis presents significant difficulties, since the signs of ovarian apoplexy are similar to signs of ectopic pregnancy, acute inflammation of the appendages or acute appendicitis.
The hallmarks are still:
- abdominal pain that occurs in the second half of the menstrual cycle,
- soreness is accentuated by the affected ovary,
- in the presence of intraperitoneal bleeding, the level of hemoglobin in the blood may be lowered.
The same symptoms can be signs of different diseases, and the disease may not proceed according to the textbook. Do not try to heal yourself – consult your doctor.
In a modern clinic, diagnostic laparoscopy is often used to treat ovarian apoplexy; with intra-abdominal bleeding, a puncture is made through the posterior fornix of the vagina. The nature of the treatment is determined in the hospital.
In cases of weak internal bleeding, conservative treatment can be prescribed under the strict supervision of a physician.
According to statistics, more than half of the cases of conservative treatment leads to the formation of adhesions and other complications that affect a woman’s reproductive capacity.
Therefore, women planning a pregnancy with ovarian apoplexy are shown laparoscopic surgery: today, laparoscopy is the least traumatic method of surgical intervention.
With heavy bleeding, an operation is possible to partially remove the ovary – resection of the ovary.
According to statistics, a relapse of the disease occurs in 15% of cases. The main reasons for the recurrence of the disease are considered to be chronic inflammation of the appendages and hormonal imbalance.