Modern concept of rendering aid to women with ovarian hemorrhages

Abstract

Aim: Analysis of modern medical care for women with ovarian hemorrhage, determination of the main diagnostic criteria that influence the choice of treatment tactics and further prognosis of the outcome of treatment of ovarian apoplexy. Material and methods: The provision of medical care to 888 women with ovarian apoplexy. Depending on the volume of hemoperitoneum, all patients were divided into three groups.: Group I – 480 (54.0%) women in whom intraabdominal bleeding did not exceed 200 ml; Group II – 283 (31.8%) patients with hemoperitoneum ranged from 200 to 500 ml; Group III – 125 (14.1%) patients with hemoperitoneum volume greater than 500 ml. Results: According to the data of the transvaginal US , a linear dependence was observed between the level of free liquid and the volume of hemoperitoneum (r=0.63, p<0.05). In 792 (89.2%) patients the diagnosis of apoplexy of the ovary and intraperitoneal hemorrhage was made to surgical intervention- on the basis of clinical picture and US data. The most frequently performed hemostatic operation was resection of the ovary – 477 (77.2%) interventions. The average volume of hemoperitoneum discovered in patients with AO, in absence of the adhesive process was (273.5±21.3) ml, whereas in patients with the expressed adhesive process of the small pelvis organs it was (141.4±35.5) ml. The cause of AO was the corpus luteum or cyst of the corpus luteum in more than the half of the cases – 348 (56.3%). Conclusions: The manifestation of the clinical symptoms in apoplexy of the ovaries depends on the volume of intraperitoneal hemorrhage. The application of laparoscopy as a main therapeutic and prophylactic method in AO allows to preserve, and sometimes to restore the reproductive function of a woman and to reduce the rate of the disease relapse development.