Ovulation syndrome
Last reviewed: 23.04.2024
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Causes of the ovulation syndrome
Pain syndrome occurs most often against the background of an excess of prostaglandins, which regulate pressure within the dominant follicle and are involved in the process of rupture of its wall with the release of a mature egg.
Symptoms of the ovulation syndrome
The rupture of the follicle is accompanied by a small amount of blood in the abdominal cavity that irritates the peritoneum and leads to the development of peritoneal symptoms. The intensity of the latter is determined by the volume of blood loss, increasing at the transition from the follicle to the intact ovarian tissue. The accumulation of blood in the Douglas space is accompanied by a feeling of heaviness in the lower abdomen, perineum, pain, irradiation to the lower limbs, sacrum, tail bone. The volume of blood loss in some cases can be significant, causing anemization of the patient and threatening her life. Ovarian rupture in terms of ovulation, accompanied by marked blood loss and a typical clinical picture, is called ovarian apoplexy.
Diagnostics of the ovulation syndrome
Diagnosis is based on the identification of typical complaints and clinical symptoms in terms of the expected ovulation, pelvic ultrasound data, puncture of the posterior vaginal fornix to confirm the presence of blood in the abdominal cavity, diagnostic laparoscopy and laparotomy.
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Treatment of the ovulation syndrome
Treatment is determined by the specific reason that caused its appearance, the nature of changes in the system of regulation of sexual function and the degree of menstrual disorders. It can be both symptomatic and pathogenetic.
Pathogenetic treatment involves the use of prostaglandin synthesis inhibitors (indomethacin, ibuprofen 1-2 days before the expected ovulation), gestagens (duphaston, uterogestan, norkolut) or combined estrogen-gestagennyh drugs. Symptomatic therapy involves the additional use of analgesics and antispasmodics in terms of ovulation.
In the surgical treatment of ovarian apoplexy, the volume of surgical intervention is determined by the degree of damage to the corresponding ovary and the state of the surrounding tissues (often inflammatory changes). With an interest in preserving reproductive function, the principle of maximum, if possible, preservation of ovarian tissue and the corresponding fallopian tube is observed. Conservative management of ovarian apoplexy includes the use of hemostatic and hemopoietic agents, anti-inflammatory and, if necessary, antibacterial therapy, prevention of adhesions.