Pain in the left fallopian tube. Inflammation of the fallopian tubes and ovaries, causes, treatment. Video: Features of inflammatory processes of the uterus and appendages. Diagnostics

Endosalpingitis is an inflammation of the mucous membrane of the fallopian tubes. Concomitant symptoms: hyperemia, swelling, deterioration of microcirculation with further cell deformation. The process most often develops from two sides, although a one-sided lesion is also possible, in particular when using an intrauterine device. The inflammatory process affects the muscular and serous membrane of the tubes, then the infection spreads to the abdominal cavity and causes damage to the epithelium of the ovary and the adjacent peritoneum.
Salpingo-oophoritis is an inflammatory process that occurs in the uterine appendages, fallopian tubes and ovaries. The consequence of such a disease may be the inability to fertilize. Such a disease may be the result of pathologies of the pelvic organs, in particular, if the disease has not been completely cured. This pathology is characterized by the formation of infiltrates, dysfunction of the mucous membranes and muscular membranes of the fallopian tubes, narrowing of the lumen of the vessels. Symptoms: dull or aching pain in the fallopian tubes and in the lower abdomen, groin and vagina.

Oophoritis is inflammation of the ovaries. Often occurs along with inflammation of the fallopian tubes. Causes: abortion, menstruation, childbirth in combination with infections of various origins. The main signs of the disease are urination disorders, pain in the fallopian tubes, lower abdomen, purulent discharge, discomfort or pain during intercourse. Treatment is prescribed depending on the nature and course of the disease. The patient is prescribed rest, in the first days ice can be applied to the lower abdomen, the use of painkillers and antibacterial drugs, sulfonamides, calcium chloride is indicated, physiotherapy is prescribed (for example, local application of quartz).
Fluid in the fallopian tubes (simple or follicular). In the tubes, from one to several closed cavities are formed, in which the secret of the fallopian tubes accumulates, as a result of which the walls of the tubes stretch and become thinner. In the presence of adhesions, the fluid accumulates again, causing inflammation in all the genital organs. The fluid that appears in the pipes causes bacteria to multiply and is a constant causative agent of infection. With prolonged hydrosalpinx, the formation of connective tissue strands occurs, provoking chronic pain.

The inflammatory process in the fallopian tubes occurs as a result of infection entering them from the external genital organs or from the abdominal cavity. This condition is dangerous with complications. The disease can drag on and become chronic. Its consequence is the obstruction of the tubal canal, which is the cause of female infertility. The symptoms of the disease are hard to miss, they are so unpleasant and obvious. You should not delay the visit to the doctor, thereby aggravating the course of inflammation of the fallopian tubes, increasing the risk of complications.

Content:

Features of the disease

Inflammation in the area of the internal genital organs occurs as a result of irritation of their mucous membranes with the waste products of various microbes. The causative agents of infection can be staphylococci, streptococci, E. coli, tuberculosis bacteria, viruses, fungi. Often the cause of the disease is the penetration into the uterus and its appendages (tubes and ovaries) of pathogens of gonorrhea, syphilis, trichomoniasis, chlamydia and other sexually transmitted infections.

The pathological process in the fallopian tube begins in the mucous membrane lining its walls, and then spreads to the muscle layer. Adhesions may form inside the tubes, blocking the lumen. As a result, partial or complete obstruction of the canal occurs. Inflammation of the fallopian tubes is called salpingitis.

Most often, this disease is combined with inflammation of the appendages (oophoritis). In this case, the doctor diagnoses salpingoophoritis (or adnexitis).

Complications and consequences of salpingitis

Approximately 20% of women with this disease develop tubal infertility, it becomes impossible to fertilize eggs in the fallopian tube. A serious consequence is an ectopic pregnancy. It occurs as a result of the fact that a fertilized egg cannot enter the uterine cavity due to damage to the wall of the uterine canal.

One of the serious complications is the development of a purulent process in the tubes, which can spread to the ovaries. The entry of pus into the abdominal cavity leads to peritonitis - a dangerous condition that requires immediate surgical intervention.

When pus enters the blood vessels, sepsis occurs. Urgent hospitalization of the woman is required to save her life. It is possible to form adhesions not only inside the uterine cavity, but also outside, as well as infection of healthy neighboring organs (for example, the occurrence of secondary appendicitis).

In the chronic form of the disease, the patient's condition periodically worsens, pains in the lower abdomen torment, which can be aggravated during menstruation or during physical exertion.

Video: Symptoms and consequences of inflammation of the fallopian tubes

Complications during pregnancy

If a woman has had salpingo-oophoritis, then her chance of conception is significantly reduced. After surgical treatment of tubal infertility, the risk of ectopic pregnancy increases.

Inflammation of the fallopian tubes leads to a narrowing of their lumen as a result of tissue swelling or fusion of the tubal canal with adhesions. Therefore, pregnancy can occur only in the event of a unilateral inflammatory process.

The presence of salpingitis in a pregnant woman often leads to miscarriage in the early stages. In the 2nd or 3rd trimester, inflammation of the appendages causes intrauterine infection of the fetus or its death.

Types of salpingitis

According to the nature of the course of the inflammatory process, acute and chronic salpingitis are distinguished.

Acute inflammation manifested by more severe and pronounced symptoms.

chronic inflammation- this is a protracted form of the disease, in which the symptoms are smoothed out, which makes it difficult to diagnose. Most often, ectopic pregnancy occurs precisely with chronic salpingitis.

The uterus has 2 tubes extending from its bottom. Depending on the localization of inflammation of the fallopian tubes, salpingitis is divided into unilateral (left-sided or right-sided), as well as bilateral, which is more difficult to eliminate.

Unilateral salpingitis, as a rule, occurs when a woman has inflammatory diseases of the organs adjacent to the fallopian tube (for example, right-sided salpingitis may accompany appendicitis).

Bilateral salpingitis occurs much more frequently.

As a result of the inflammatory process, fluid or pus may accumulate in the tubal canal.

Hydrosalpinx (dropsy) occurs when, due to a violation of the patency of the pipe, blood and lymph begin to accumulate in it, penetrating through the swollen wall.

Pyosalpingitis is a purulent inflammation (usually bilateral).

Causes of the disease

The cause of inflammation of the fallopian tubes is the reproduction of pathogenic microorganisms in them. There are the following options for infection of the pipes:

The penetration of microbes from the external urogenital organs into the uterine cavity, and from there into the fallopian tubes and ovaries (ascending path). In a healthy female body, the uterus is protected from infection. In her neck there is a dense plug of mucus, which is produced by special glands. A decrease in mucus production and a violation of its composition can occur due to endocrine pathologies and hormonal failure.
The entry of microbes into the tubes directly from the uterine cavity. The infection can be introduced during an abortion, diagnostic procedures, operations, as well as during the installation of an intrauterine device.
Infection from the outside, that is, infection in the tubes and uterine cavity from the abdominal cavity, where the intestines, bladder and other organs of the small pelvis are located;
Penetration of infection into the uterus and appendages through the blood with pneumonia, viral flu or tonsillitis.
Spread of infection from the inflamed ovaries to the tubes and uterine cavity (descending path). In turn, inflammation of the ovaries can occur, for example, after the formation of cysts or tumors in them.

The process of inflammation of the fallopian tubes can occur due to non-compliance with hygiene rules (rare change of pads, improper care of the genitals), frequent douching, hypothermia of the body. The reason for the development of the inflammatory process may be a weakening of the immune system as a result of various diseases, poor nutrition, and nervous stress.

At risk are women who are sexually promiscuous. The likelihood of an inflammatory process in the uterus is increased in women who are physically weakened, suffering from diabetes or having thyroid disease.

Video: Features of inflammatory processes of the uterus and appendages. Diagnostics

Symptoms of salpingitis

The first signs by which it can be assumed that a woman has inflammation of the fallopian tubes are:

The appearance of yellow or greenish profuse vaginal discharge with an unpleasant odor. Depending on the type of infection, they can be foamy, purulent, containing traces of blood.
Pain in the lower abdomen (on one side or both at once). The pain extends to the lower back and sacrum.
Frequent and painful urination as a result of concomitant lesions of the urinary tract.
Discomfort during sexual intercourse, increased discomfort after it.
Temperature increase up to 37.5°-39°С.
Delayed menstruation, the appearance of spotting on any days of the cycle between menstruation.
Digestive disorder.

The result is the absence of pregnancy with regular sex without the use of contraceptives.

Acute salpingitis

With this form of the disease, the body temperature rises and cutting pains appear in the groin area. At the same time, weakness occurs, the heartbeat quickens, and aching pains in the lower back are disturbing. The intensity of unusual secretions from the genitals increases sharply. Exacerbated symptoms of urination disorders and bowel function.

Chronic salpingitis

The patient can feel satisfactory until the moment of exacerbation of the disease. During periods of remission, body temperature usually, if it rises, does not exceed 37.2°-37.5°. Greenish discharge is scanty. However, a slight aching pain in the lower abdomen is a constant concern. An exacerbation of a chronic disease can occur after a cold, hypothermia of the legs and lower abdomen. The cause of the exacerbation may be emotional stress or constant overwork.

Purulent salpingitis

This condition most often develops with gonorrhea. A purulent inflammatory process also occurs after operations, if the infection enters the tubes when using surgical instruments. The acute form of such a disease is characterized by a sharp increase in temperature to 38 ° -39 °, chills, severe sweating. The discharge is foul-smelling and contains pus, which makes it grayish-yellow. There is irritation of the skin in the vulva. Sharply aggravated cystitis.

Especially dangerous is chronic purulent salpingo-oophoritis, in which the production of sex hormones in the ovaries is disrupted, which leads to an irregular cycle, increased menstrual pain, fluctuations in the intensity and duration of menstruation.

Diagnostics

Inflammation of the fallopian tubes is detected by the presence of characteristic symptoms, as well as by the results of a biochemical analysis of a smear from the cervix taken during a gynecological examination.

In the microflora of the vagina, infectious agents are found that could cause an inflammatory process. Clarify the sensitivity of pathogens to antibiotics of various types allows bacterial culture of vaginal mucus.

With the help of ultrasound, the condition of the fallopian tubes is established, the wall thickness, the width of the lumen are measured. Signs of the presence of salpingitis are thickening of the walls, the formation of adhesions, and the accumulation of fluid. The size of the ovaries is determined. Ultrasound allows you to notice the presence of changes in the structure of the endometrium, as well as to examine neighboring organs of the small pelvis. An ultrasound examination is performed abdominally (using an external probe) or transvaginally (using a vaginal probe).

Diagnostic laparoscopy allows you to examine the uterus and tubes from the inside using an optical camera inserted into the cavity through a small puncture in the abdominal wall. The procedure is performed under anesthesia, as it is a minimally invasive operation.

Metrosalpingography is performed. It is an X-ray examination in which the uterine cavity is filled with a special solution (contrast). By the speed of its progress through the fallopian tubes, the presence or absence of adhesions in them is determined.

Treatment

It is carried out medically or surgically. Physiotherapy procedures are also prescribed, such as electrophoresis, UHF therapy, therapeutic baths. The method of treatment depends on the severity of the disease and the cause of its occurrence.

Medical therapy

Antibacterial and anti-inflammatory treatment is carried out, as well as means to increase immunity.

Antibiotics assigned first. Often they are used in various combinations, since pathogens of several infections are found in the microflora, differing in different sensitivity to antibacterial drugs. In acute and chronic inflammation of the fallopian tubes, drugs such as ampicillin, erythromycin, tetracycline, furazolidone are used. With their help, the growth and reproduction of pathogenic bacteria is suppressed.

With purulent inflammation, cefotaxime or cephalicin (antibacterial drugs of the cephalosporin group) is used. If it is established that the causative agents of the infection are protozoa (Trichomonas, Chlamydia), then metronidazole is prescribed.

Anti-inflammatory drugs are used as antipyretics and painkillers, help restore the condition of inflamed tissues. Derivatives of ibuprofen, paracetamol, butadione (phenylbutazone) are used.

Immunomodulators are prescribed to enhance the body's own resistance to the damaging effects of harmful microbes. Such funds are used in individual doses, taking into account the weight of the patient and her contraindications. Drugs such as polyoxidonium, imunofan, groprinosin are used.

Vitamins. Taking complex preparations with a high content of vitamins C, E, as well as various mineral components helps to improve metabolism and accelerate the regeneration of cells damaged by microbes.

Addition: Sometimes the use of traditional medicine is allowed: medicinal herbal decoctions for baths, douching, making tampons. They are used as anti-inflammatory, analgesic, antipyretic and restorative agents that complement drug therapy. You can not start self-treatment without knowing the exact diagnosis. It is especially contraindicated for allergy sufferers. Plants such as calendula, chamomile, rosemary, valerian, sage, juniper and others are used.

Surgery

Indications for its implementation are:

ineffectiveness of antibiotics;
detection of tumors in the appendages (it was their appearance that could lead to inflammation of the fallopian tubes);
the presence of purulent abscesses in the uterus and appendages;
tubal infertility.

During the operation, adhesions are removed, the canal is cleaned of pus, and it is treated with disinfectant solutions. Perhaps partial or complete removal of the fallopian tubes.

Methods such as laparoscopy (most often a diagnostic procedure is combined with a therapeutic one), as well as laparotomy, are used. Laparoscopy is a less traumatic method. For the introduction of instruments and surgical procedures, it is required to make several punctures in the peritoneum. With extensive purulent processes and the detection of tumors, a laparotomy is performed (an incision is made on the abdomen).

Disease prevention

Compliance with certain rules reduces the risk of developing inflammation of the fallopian tubes. So, you should remember about the danger of contracting sexually transmitted diseases, use condoms, have a reliable sexual partner.

It is necessary to carefully look after the genitals, avoid douching without a doctor's prescription. It is advisable to visit a gynecologist at least once a year, undergo medical examinations, pay attention to the appearance of unusual discharge, as well as pain in the groin area.

It requires a reasonable approach to the choice of clothing in order to prevent hypothermia, especially the lower body. It is necessary to strengthen the immune system by all means (play sports, eat right, avoid smoking and other bad habits). Do not abuse drugs (for example, antibiotics) that can kill the beneficial microflora in the body.

What is inflammation of the fallopian tubes and why does it develop?

In a medical environment, inflammation of the fallopian tubes is commonly called salpingitis. This disease in the vast majority of cases has an infectious etiology. Pathogenic microflora can penetrate into the cavity of the fallopian tubes only in 2 main ways - from the uterus and from the abdominal cavity. In the vast majority of cases, it is the first variant of infection that is implemented. At the same time, this disease can develop against the background of active reproduction of both specific (chlamydia, gonococci) and nonspecific microflora. Cause inflammation of the appendages, not only pathogenic, but also conditionally pathogenic microorganisms. However, this requires a decrease in general and / or local immunity. A similar situation can be observed in case of hypothermia or the presence of diseases that reduce immunity. In addition, the protective properties of the body also decrease during pregnancy, so during this period women should be especially careful.

How is inflammation of the fallopian tubes most often manifested?

The main symptom here is pulling pain in the lower abdomen. At the same time, they are characteristic of both chronic and acute forms of the disease. Depending on which tube is affected, pain occurs in the lower abdomen on the left, on the right, or on both sides. It is worth noting that the chronic form of the disease is dangerous because adhesions can form in the pipes. In this case, the process of passage of the egg to the uterus is very often disrupted. Strictly speaking, spermatozoa in this case are usually not able to reach the ampullar part of the fallopian tubes and fertilize the egg. As a result, a woman develops secondary infertility. The acute form of the disease most often does not lead to such a complication. Its main symptom is pain in the lower abdomen, usually aching or bursting. In addition, common signs of an ongoing infectious disease are often observed. We are talking about an increase in body temperature, as well as weakness and decreased performance.

How to cure inflammation of the fallopian tubes?

Most often, the course of treatment of this disease begins with the appointment of antibacterial drugs. At the same time, the doctor initially offers the patient funds with a fairly wide spectrum of action. After a specific pathogen is established and its sensitivity to certain antibiotics is determined, the drugs are changed to the most effective ones. Usually, after a few days, the pain in the lower abdomen disappears, but the medication should be taken exactly as much as the doctor said. In the case when the patient has already managed to form adhesions inside the fallopian tubes, it is necessary to perform laparoscopy. At the same time, special enzymes are introduced that will prevent their re-formation of adhesions, and existing ones are dissected. It is worth noting that the earlier inflammation of the uterine appendages is detected, the easier it is to treat. Therefore, as soon as a woman begins to feel recurring pains in the lower abdomen, she should consult a gynecologist.

Ectopic pregnancy occurs when the implantation of a fertilized egg occurs not in the uterine cavity, but in another place. Pregnancy occurs from the moment of the fusion of the sperm and the egg. Normally, a fertilized egg, or zygote, attaches itself to the lining of the uterus.

Most often, an ectopic, or ectopic, pregnancy develops in one of the fallopian tubes, through which eggs enter the uterus (fallopian tubes). This type of pathology is also known as tubal pregnancy. However, in some cases, an ectopic pregnancy develops in the abdomen, ovary, or cervix.

Due to many factors, an ectopic pregnancy cannot proceed normally. The zygote cannot survive outside the uterine cavity, and the structures that form can destroy many maternal tissues. If left untreated, serious bleeding can develop, which is an immediate threat to the woman's life.

Symptoms

Types of ectopic pregnancy and their frequency (click to enlarge)

At the initial stages, an ectopic pregnancy may not manifest itself in any way. In some cases, there may be signs of a normal pregnancy, such as the cessation of menstruation, breast tenderness and nausea.

The test for an ectopic pregnancy will be positive, because regardless of its location in the body of a woman, a fertilized egg produces hCG. However, the test cannot reveal this location and cannot be used to definitively diagnose this pathology.

Often, the first warning signs of an ectopic pregnancy are minor bleeding from the genital tract, accompanied by or discomfort in the perineum. If blood flows from the fallopian tube, then pain in the shoulder on the side of the pathological process is possible, as well as the urge to defecate, depending on where the blood accumulates and which nerves are irritated. If the fallopian tube ruptures, then there is severe internal bleeding, which is manifested by severe weakness, dizziness, pallor, cold sweat, loss of consciousness and shock.

The reasons

A tubal pregnancy, the most common type of ectopia, occurs when a zygote gets stuck in it on its way to the uterus, often due to damage to the tube due to inflammation or irregular shape. In addition, hormonal disorders and the abnormal development of the fertilized egg itself play a role.

Risk factors

Approximately 20 pregnancies out of every 1000 are ectopic. There are many risk factors for developing this condition, including:

Ectopic pregnancy in the past. If a woman has had this disease at least once, then the risk of ectopic in her increases.
Inflammation or infection. Inflammation of the fallopian tube, or salpingitis, as well as infectious processes in the uterus and appendages increase the risk of the disease. Often the cause of these diseases are chlamydia and gonorrhea.
Anatomical anomalies. Ectopic pregnancy often develops in women with fallopian tube anomalies and injuries, including after surgery. It is noteworthy that even plastic and tubal reconstruction surgery can increase the risk.
Choice of contraceptives. The development of a zygote outside the uterus is more likely if the woman is using an intrauterine device or has had a tubal ligation.
Smoking. The components of tobacco smoke and smoking experience are directly associated with the occurrence of this disease.

Diagnostics

A simple physical examination on a gynecological chair in most cases is not enough to diagnose an ectopic pregnancy. The diagnosis is usually confirmed by imaging methods such as (including transvaginal).

Other research methods, such as CT and MRI, are practically not used due to the urgency of the situation.

In some extremely severe cases, when the patient's life is in danger, the diagnosis is carried out immediately during the operation.

Treatment

The standard treatment for ectopic pregnancy is surgery, the extent of which depends on the location of the zygote. In tubal pregnancy, a laparoscopic tubectomy, or removal of the affected fallopian tube, is performed. However, there are other therapies that are widely used in Western clinics.

So, if an ectopic pregnancy was detected at the earliest stages, the patient may be administered methotrexate- a drug that stops the growth and development of germ cells, and also destroys already formed embryonic structures.

After surgery, hCG levels in the blood are monitored to ensure that the ectopic tissue has been completely removed. If the level of this hormone decreases slowly, then the patient may be given an injection of methotrexate.

It is impossible to prevent pathology, but you can reduce the risk of its development. For example, limit the number of your sexual partners and practice sex with a condom to prevent the transmission of STDs and lower your risk of pelvic inflammatory disease. When planning a pregnancy, quit smoking - this will also reduce the likelihood of pathology.

One of the most important periods in the life of every woman is pregnancy, but, unfortunately, it does not always end with the birth of a baby. An ectopic pregnancy today has become not so rare, and it can be very difficult to understand on your own whether everything is in order with the health of the expectant mother.

Of course, at the slightest doubt, it is necessary to consult a specialist, but still there are a number of symptoms and signs that will help you figure out if there is room for panic, long before visiting a doctor.

An ectopic pregnancy is quite difficult to distinguish from a normal one, because it can cleverly disguise itself, especially in the very early stages. It is accompanied by the same signs as a normal pregnancy: delayed menstruation, toxicosis, swelling of the mammary glands. A pharmacy test will show exactly the same two strips, since the level of the hCG hormone will rise, as in a normal pregnancy. But still, an ectopic pregnancy has special, unique symptoms. To begin with, we will consider all types of pain during an ectopic pregnancy.

The nature of pain during ectopic pregnancy: when to sound the alarm

Any discomfort in the lower abdomen at the initial stage of pregnancy should alert the expectant mother. Pain during ectopic pregnancy is the most common symptom of this pathology, but you still need to be able to distinguish them, since the cause of pain in the abdomen can be associated with completely different, but no less serious diseases. Let's try to understand what kind of pain during an ectopic pregnancy can appear.

To begin with, we will characterize them in more detail: pain occurs when changing the position of the body, as a result of sudden movements or during fast walking. Most often, the stomach hurts only on one side - where the fallopian tube is damaged, but if the pregnancy is cervical, then painful sensations appear closer to the middle of the abdomen, just below the navel. As for the period of ectopic pregnancy, at which pain occurs, it is individual for each woman. It all depends on the location of the fetus: if it develops in the ampulla of the fallopian tube, then discomfort will appear at about 8-9 weeks, but if on the isthmus, then trouble should be expected already at 5-6.

I would also like to dispel the popular myth among the people that an ectopic pregnancy is not accompanied by toxicosis. There is toxicosis both during normal pregnancy and during ectopic, but only in the second case it has a slightly different character. With an ectopic pregnancy, pain and nausea are more pronounced than with a normal one. If, during normal implantation of the fetal egg, the pain sensations are pulling in nature and cause slight discomfort, then during an ectopic pregnancy, they manifest themselves in the form of acute spasms and sharp outbreaks of pain.

It is worth emphasizing once again that in every woman, pain during the pathological course of pregnancy manifests itself differently and at different times, sometimes they may not be at all, while blood during an ectopic pregnancy is present in the discharge of most patients. Abundant or spotting bleeding from the vagina is caused by the fact that the embryo is fixed in an area where there are more blood vessels than in the uterus itself. Quite rarely, but still there are continuous bleeding that pose a threat to the life of a pregnant woman: sometimes doctors have to remove the uterus completely in order to avoid death.

With an ectopic pregnancy, pain most often manifests itself instantly - sometimes one awkward movement is enough, while they fade slowly, as if gradually receding. In case of acute pain, a woman must be placed on her back and helped to take the most convenient and comfortable position in which the pain will pass. By nature, the pain can be both acute and barely perceptible, but, both in the first and in the second case, you should not panic. Wait for the moment when the pain will go away - only after that it will be possible to get up. However, do not forget that any careless movement can lead to a worsening of the condition.

Secondary signs of ectopic pregnancy

In addition to the main signs of an ectopic pregnancy, one should not forget about the secondary ones, including an increase in body temperature, especially in the late afternoon, a sharp drop in blood pressure and frequent dizziness due to a decrease in hemoglobin levels in the blood. In especially neglected situations, the possibility of developing anemia cannot be ruled out. And yet, such symptoms are quite subjective, they are individual for each woman, while spotting during an ectopic pregnancy is observed in everyone.

If you notice at least one of the listed signs in yourself, immediately contact a specialist and do an ultrasound - only it will show exactly if there are reasons for concern. An ultrasound examination will help not only to make sure that your pregnancy is proceeding normally, but also to identify other pathologies in the development of the baby in time.

It is known that initially the pathology and the norm are very similar in signs. But there are also differences. They must be noticed in time and the necessary measures taken.

Absolutely asymptomatic pathological pregnancy does not develop! It is possible that the patient does not notice some “bells”.

Usually, the first symptoms of an ectopic pregnancy occur two weeks after the day of ovulation. And abortion occurs spontaneously at 6-8 weeks. In this interval, it is necessary to establish the pathology.

Diagnostic signs include:

soreness;
atypical discharge;
bad feeling.

Let's take a closer look at each group.

What kind of pain is possible with an ectopic pregnancy?

The most painful place is the stomach. And immediately the pain is localized only on the left, and sometimes only on the right - where the pathological process occurs. With the growth of the embryo, the painful condition intensifies, passing to the entire abdomen. A woman perceives such pain as aching. It is permanent, and at times it is sharp, prickly.

Initially, the intensity of pain is small. The patient may not notice these signs. Especially when this condition arose for the first time. After all, similar pains occur in the uterus normally. This fact is explained by the stretching of its walls, which is due to the rapid increase in the fetus. Without experience, a woman is unlikely to recognize the first signals of the disease herself.

The non-physiological development of the embryo, like the normal one, can provoke pain syndromes in the chest. The female body is intensively preparing for feeding the child. Accordingly, the mammary glands swell. Also, sensations of pain during defecation are not excluded.

If blood enters the peritoneum, then the pain is localized in the abdomen and other parts of the body. This condition is very dangerous, seeking medical help is extremely necessary!

Menstruation during ectopic pregnancy

It has long been known that menstruation stops during an uncomplicated pregnancy. Although at times there are dangerous discharges of blood. But you can't call it the norm. What about pathology?

The body first defines ectopic pathology as the norm and begins to prepare for bearing a child. As a result, menstruation stops. This happens because the development of the fetus, wherever it occurs, involves the release of the "hormone of pregnancy" - progesterone.

But small discharge during ectopic pregnancy is possible. In some ways, they are similar to menstruation. However, this is bleeding that begins due to rupture of capillaries. A sign of bleeding is a brighter color of the blood. 60% of patients have these symptoms. They can be called the first "bells" of disorder in the body. Along with bleeding, pulling pain may also appear. Usually its localization is the lower abdomen with a shift to the left or right. Moreover, a woman should not miss such signals.

The following group of symptoms:

fainting or fainting;
pressure drop;
heaviness in the perineum;
non-critical temperature increase;
intestinal pain;
diarrhea;
nausea;
dizziness.

Sometimes my shoulder hurts. This usually happens if a woman lies. It seemed, what is the connection between the shoulder and pregnancy? However, it is. When internal hemorrhages occur, the phrenic nerve can become irritated, causing pain.

If the patient's pregnancy is not typical, then she needs to urgently consult a doctor. Do not wait for damage to organ tissues and bad consequences.

How is ectopic pathology diagnosed?

Now medicine has a large arsenal of ways to diagnose a dangerous condition. Establishing a timely diagnosis is an important task. After all, the further condition of the woman depends on this. Of course, it is difficult to identify ectopic pathology by external symptoms.

Anyone can feel unwell for a variety of reasons. But the appearance of painful sensations in the abdomen, in addition, still allows you to suspect something was wrong. That's when you need to urgently conduct an examination in the clinic.

Based on the initial complaints of the patient, the doctor can assume an ectopic pathology and conduct the necessary studies. The main thing is to be in time before the damage to the pipe and the state of shock.

If the treatment is carried out before the interruption phase, then nothing threatens the patient, but in dangerous times even an operation may not save - up to 30% of patients die. In addition, tubal-sparing surgery increases the patient's chances of re-pregnancy and carrying a normal baby. This is possible with timely treatment.

What clarifying procedures does a gynecologist perform?

First, the size of the uterus looks. Their inconsistency with gestational age leads to the conclusion that there is no embryo in the uterine cavity. After that, the doctor examines the blood counts, examines the urine.

This indicator is quite informative. Normally, it increases daily. Doubles every two days. It is easy to determine the duration of pregnancy. However, with pathology, hCG practically does not increase. To be sure, you need to donate blood repeatedly with interruptions. By the low level of hCG during pregnancy, its nature is judged. Such a study is not the main thing in diagnosis, but, based on its results, the doctor begins a further study of the patient's condition.

The next most important indicator is the amount of progesterone. In pathology, it is much lower.

Finally, the gynecologist prescribes an ultrasound examination. The monitor shows the absence of a fetus in the uterus. If other signs of pregnancy are present, a logical conclusion is made about its non-physiological course.

More information is obtained from a vaginal ultrasound. This procedure determines the monthly pregnancy. With external ultrasound, only a six-week period is set. Of course, this method is far from 100%. Uterine blood clots can mislead any device. The error in the study is about 10%.

Does the test detect an ectopic pregnancy?

A timely diagnosis with such a pathology is very important, because women are interested in the possibility of self-diagnosis at home. Yes, and all other methods of examination become informative literally in the last safe terms. It is impossible to allow damage to the pipes and bring to an urgent operation.

Immediately make a reservation that the usual test pathology can not be detected. But there is a new innovative development - the INEXSCREEN test cassette for determining ectopic pregnancy. The operation of this test is different from the usual one.

The testing is based on immunochromatographic analysis. If the usual test detects an increase in β-hCG in a urine sample, then INEXSCREEN determines two other forms - intact and modified. These indicators in the physiological course of pregnancy are greater than in the pathological. This is a new way to determine ectopic pregnancy, but it is highly informative. Moreover, using this test, it is possible, with a high degree of probability, not to miss the safe terms of treatment. The reliability of this method is about 90%.

Any patient at home is able to use it, which gives an additional benefit. INEXSCREEN can diagnose pathology three weeks after ovulation. Still, it is faster than with all other methods. Note that the price and presence in most pharmacies makes this diagnostic method available to all patients.

In order for the information content of the test to be as high as possible, it is necessary:

examine only fresh urine;
do not use a cassette with damaged packaging;
read the instructions.

In conclusion, we wish women to be more attentive to themselves, to notice all the signals of trouble in their bodies. Only then is timely diagnosis possible, and, consequently, not belated treatment. And only then the terrible consequences of the disease can be prevented.

One of the most common types of gynecological diseases is salpingitis, which is quite difficult to treat with conservative methods, and is also fraught with the development of infertility. Salpingitis is called inflammation of the fallopian tubes, which begins to develop due to the penetration of infection into the cavity of the reproductive organs. First, the pathology is localized on the mucous surfaces of the uterine appendages, then the progressive inflammation of the ovaries begins to spread further and affects the structures of the muscle layer in the fallopian tubes. In the absence of emergency drug therapy, adhesions are formed in the fallopian tubes, which leads to the formation of their obstruction and all the ensuing consequences.

In the presented review, we will take a closer look at what contributes to the formation of inflammation of the fallopian tubes and ovaries, varieties of this disease, symptomatic signs and basic principles of therapeutic control, as well as the likelihood of surgical intervention and alternative treatment methods.

Causes of pathology

Often, infection goes in the direction from the bottom up, that is, through the vaginal cavity. From where infectious microorganisms move through the cervical canal into the cavity of the uterine organ, and finally, the end point of their movement is the uterine tubes, where the process of inflammation begins to progress.

It is also worth noting that inflammation of the fallopian tubes can get its start through descending pathways of infection, that is, through the sigmoid colon or appendix. Much less often, the formation of pathology occurs through the bloodstream from any progressive focus of an infectious disease developing in the female body.

There are a huge number of provoking factors contributing to the development of this pathology, the most common are infectious diseases transmitted through sexual intimacy of partners, in the form of:

chlamydia;
gonorrhea;
papillomavirus infection;
genital herpes;
trichomoniasis;

The progression of these diseases in a woman contributes to the development of inflammation of the urinary system and fallopian tubes. The insidiousness of the development of most of these diseases lies in the fact that they occur without the manifestation of any symptomatic signs, as a result of which, women do not visit the gynecological office for a long period, and the pathology becomes chronic. The presence of bacterial microflora for a long period on the mucous surfaces of the genital organs contributes to a decrease in the immune defense system and a decrease in the intensity of blood circulation in these organs. Against this background, with the slightest impact of an additional provoking factor in the form of a cold, depression or stress, the inflammatory infection begins to move up to damage the fallopian tubes.

Salpingitis with venereal disease

After the penetration of infectious microorganisms into the mucous structure of the fallopian tubes, their intensive reproduction begins. As a result, the inner walls of the fallopian tubes become inflamed, which leads to impaired blood circulation. Then, inflammatory processes penetrate into all layers of the fallopian tubes, which contributes to an increase in their thickness and activation of adhesive reactions, which leads to blockage of the passage in the tubes and the development of infertility. With the progression of a bacterial-type infection, accumulations of a purulent nature may appear in the pipes. Often, inflammation of the fallopian tubes, which develops due to the negative impact of sexually transmitted diseases, has a bilateral course.

It is worth noting that when conducting a promiscuous sexual life and entering into intimacy with various sexual partners, the likelihood of an inflammatory process in the fallopian tubes increases several times. This is due to the fact that such an intimate lifestyle increases the risk of contracting a sexually transmitted disease, and possibly several of their varieties at once, which is referred to as a microbial association. All this leads to a decrease in immunity and the destruction of the barrier that protects the mucous surfaces of the genital organs from the penetration of bacterial microorganisms.

Mechanical causes of salpingitis

The development of inflammation of the tubes can contribute to various damage to the mucous surfaces of a mechanical nature, which include:

injuries received in the process of labor activity;
premature termination of pregnancy;
setting the IUD, which can be perceived by the body as the penetration of a foreign body, against which allergic inflammatory reactions can start, which also leads to a decrease in the local immune defense system;
intrauterine diagnostics: salpingoscopy or metrosalpingography.

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Inflammation of the tubes can also get its start from a progressive disease in the cavity near the located organs (intestine, bladder), through the bloodstream or lymphatic vessels and lymph. Pathological phenomena that can contribute to the occurrence of salpingitis include: colitis, appendicitis, inflammation of the ovaries, pelvic peritonitis.

The transition of the infection from the organs affected by the presented pathologies to the fallopian tubes occurs against the background of their close proximity to the anatomical location.

Additional reasons include: intimacy of partners during the menstrual cycle, the onset of sexual activity from an early age, and non-traditional forms of sexual intimacy of partners.

Varieties of pathology

Inflammation of the fallopian tubes, or salpingitis, is classified into several varieties depending on the location of the formation of the pathology, its nature and the process of progression. Salpingitis can be:

chronic;
sharp;
right - or left-sided;
purulent character;
flowing along with the development of oophoritis.

The development of acute salpingitis

This form of pathology originates from the penetration of infectious microflora into the cavity of the fallopian tubes against the background of a sharp drop in the level of the immune defense system. Most often, the formation of such a process occurs against the background of oophoritis, which is characterized as inflammation of the ovaries, or during an ectopic pregnancy.

The development of acute inflammatory reactions in the area of the fallopian tubes is characterized by the formation of pronounced symptoms, in the form of:

a sharp increase in temperature indicators;
weakness and malaise throughout the body;
increased heart rate;
the appearance of acute pain in the groin area;
discharge of an abnormal vaginal secretion, which may be purulent, frothy or bloody, depending on the type of pathogen;
violation of the functional ability of the urinary system of organs.

There may also be a decrease in the functionality of the organs of the gastrointestinal tract, manifested by a violation of the stool and signs of diarrhea.

The development of chronic pathology

Salpingitis, which has a chronic manifestation, is characterized by the formation of mild symptomatic signs and the preservation of a satisfactory state of health. The appearance of meager vaginal discharge, and constant aching pain in the lower abdomen is noted. Temperature indicators rarely exceed the limits of the norm, but if this happens, they do not exceed 37.2 degrees.

This type of pathology is characterized by an undulating course with alternating periods of relapse and exacerbation. Chronic salpingitis often provokes a violation of the cyclicity and abundance of menstrual flow and has the highest likelihood of developing infertility.

The course of purulent salpingitis

The formation of a purulent form of salping pathology is preceded by the penetration of gonorrheal infectious microorganisms into the cavity of the uterine organ and tubes, which can occur against the background of:

spontaneous miscarriage;
premature surgical termination of pregnancy;
use of an expired intrauterine device.

The main signs of purulent inflammation of the fallopian tubes are the appearance of the following symptoms: chills, fever, sharp pain in the lower abdomen.

Salpingoophoritis

The most common form of development of salpingitis is considered to be its formation in combination with oophoritis, that is, inflammation of the ovaries, which is referred to in medicine as salpingo-oophoritis.

Causes of occurrence:

decreased immunity;
hypothermia;
the negative impact of frequent stressful situations.

Timely treatment of this form of pathology will have favorable prognosis, otherwise complications may arise that are fraught with infertility and the development of ovarian hypofunction.

Symptoms

With inflammation of the fallopian tubes, the symptoms indicating the development of this pathology depend on the location of the focus of infection, the characteristic features of inflammation and the possible reactions of the female body to the course of the disease. An impressive effect on the symptoms and treatment of inflammation of the fallopian tubes is exerted by concomitant diseases in the body of women, which is more related to pathologies of the venereal type. The main clinical manifestations of progressive inflammation in the fallopian tubes include:

the appearance of pain in the lower third of the abdomen;
an increase in temperature indicators, which often exceed subfebrile limits (with a purulent form of pathology);
the appearance of vaginal lubrication, which has a pathological character;
the appearance of pain during sexual contact with a partner;
pathogenic change in cyclicity, profusion and periodicity of menstruation;
inability to conceive a child.

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Signs and treatment of bilateral salpingo-oophoritis

The greatest likelihood of developing infertility occurs with 2-sided chronic type salpingitis, which is characterized by the defeat of two fallopian tubes at once and the progression of the adhesive process. When diagnosing unilateral salpingitis, the risk of developing infertility is halved, since one tube remains functional.

Treatment of salpingitis

With inflammation of the fallopian tubes, treatment can be carried out by various methods. Depending on the severity of the pathology, the attending physician, based on the collected results of diagnostic measures, may prescribe medication, surgical or alternative treatment for the disease.

Medical therapy

Drug therapy of salpingitis consists in eliminating infectious microflora, taking anti-inflammatory drugs and increasing immunity. First of all, to eliminate the inflammatory process, one of the following antibacterial drugs is prescribed:

Ampicillin, which prevents the development of bacterial microorganisms, by inhibiting the synthesis of their walls. It is diluted with novocaine and administered by intramuscular injection every 6 hours, 500 mg each;
Ampiox is a drug that has both antibacterial and bactericidal spectrum of action. It is used three times a day, inside 500 mg;
Klaforan is a powdered preparation that has a destructive effect on the cellular elements of bacterial microorganisms, which stops the processes of their reproduction. Recommended for intravenous or intramuscular administration in the amount of one gram, three times a day;
Erythromycin is an encapsulated drug that helps prevent the growth of bacteria in the focus of the inflammatory process. It is administered orally four times a day, one capsule.
Klion, or Metronidazole, stops the reproduction of bacterial microorganisms and Trichomonas. It is administered orally, one tablet, three times a day.

To provide a preventive effect against the formation of dysbacteriosis, the intake of antibacterial drugs is combined with medicines that have an antifungal effect, which include Fluconazole and Ketoconazole, and probiotics are also prescribed in the form of Linex or Vitaflora.

To reduce the inflammatory process, drugs with an anti-inflammatory spectrum of action are prescribed, in the form of: Nurofen, Butadione, Paracetamol and Advil, which are combined with the intake of vitamin complexes and antioxidants that ensure the normalization of metabolic processes.

Among the vitamin complexes necessary for salpingitis, it is recommended to take:

vitamins of group E;
ascorbic acid;
cocarboxylase.

To increase the likelihood of recovery will help taking immunomodulatory drugs, in the form of: Imunofan, Polyoxidonium or Griprinosin.

The dosage and duration of the use of medications should be determined only by the attending physician. Self-medication is highly discouraged in such a complex pathological process.

Methods of surgical treatment

If there is no effectiveness of conservative treatment through the use of medications, in acute or chronic salpingitis, surgical intervention may be prescribed. It is necessary to treat inflammation of the fallopian tubes surgically in the following situations:

when a tumor-like neoplasm occurs in the cavity of the uterine appendages;
in the formation of purulent accumulations;
when diagnosing infertility with an unclear genesis;
with the formation of adhesive processes and obstruction of both fallopian tubes.

Surgery can be performed by laparoscopy, that is, using a special device that is inserted through a microscopic opening in the abdomen. If this operation does not end with success, then a laparotomy operation is performed, which consists in carrying out the necessary manipulations by making a large incision in the anterior abdominal wall.

ethnoscience

With an uncomplicated course of inflammatory salpingitis, non-traditional treatment methods can be used, in the form of:

the use of baths with sage, rosemary or valerian;
douching with infusions or decoctions of medicinal plants (calendula, linden, sage or bergenia);
decoctions for oral administration, prepared on the basis of birch bark, viburnum flowers or coltsfoot.

It is better to prevent the occurrence of inflammatory pathology in the fallopian tubes than to subsequently treat it, and for this you need to be more attentive to the health of the reproductive system of organs, eliminate any venereal pathologies in a timely manner, regularly undergo gynecological examination and exclude frequent change of sexual partners.

And, as a result, the development of tubal obstruction.

Inflammation always affects both tubes, but the severity of pathological changes in them may be different.

Salpingitis is most often a chronic disease, exacerbations of which occur against the background of a decrease in immunity or hypothermia. Most often, not only the fallopian tubes become inflamed, but also the ovaries.

Symptoms of salpingitis

Clinical manifestations of salpingitis largely depend on the stage of the disease.

The following symptoms are characteristic of the acute stage:

pains of varying intensity in the lower abdomen (as a rule, they are more pronounced on the side where the pathological process develops most intensively);
cycle disorders;
the appearance or intensification of secretions from the genital tract;
temperature rise.

With the transition of the disease into a chronic form, the symptoms become erased. During periods of remission, there are constant pains in the lower abdomen, which can be aggravated by defecation and during sexual intercourse. If obstruction of the fallopian tubes develops, then infertility occurs.

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Diagnosis of salpingitis

First of all, the gynecologist conducts a survey of the patient, during which he finds out whether the disease is associated with a change of partner, complicated childbirth, gynecological manipulations, surgical abortion, and so on.

Diagnosis of salpingitis is based on data obtained as a result of physical, instrumental and laboratory studies.

Gynecological examination with acute inflammation of the fallopian tubes is extremely painful for the patient. Through the abdominal anterior wall, the doctor palpates and finds one or two-sided inflammation of the fallopian tubes in the area of the appendages. In the chronic form of salpingitis, due to the growth of connective tissue, the appendages are inactive.

A blood test for salpingitis shows the presence of an inflammatory process, which is characterized by an increase in ESR and leukocytosis with a shift in the formula to the left.

The results of the smear, which is taken from the cervical canal, vagina and urethra, can identify the causes of inflammation and determine the sensitivity of pathogens to antibiotics.

Salpingitis caused by chlamydia, tuberculosis, gonorrhea is confirmed by ELISA and PCR.

With the help of transabdominal or transvaginal ultrasound, thickening of the fallopian tubes can be seen, as well as the presence of effusion and adhesions in the small pelvis. With pyosalpinx or hydrosalpinx, ultrasound shows a tumor-like change in the fallopian tube.

Diagnostic laparoscopy is indicated to rule out ovarian apoplexy, pyosalpinx rupture, ectopic pregnancy, and acute appendicitis.

Treatment of salpingitis

In the acute stage of inflammation and exacerbation of the chronic form of salpingitis, treatment in a hospital is necessary. The patient is prescribed bed rest, a sparing diet and cold on the lower abdomen.

After finding out the reasons for the development of salpingitis and obtaining the results of the seeding tank, antimicrobial therapy is prescribed. Antibiotics from the group of tetracyclines, macrolides, aminoglycosides, cephalosporins and penicillins may be prescribed. The duration of the course of treatment is determined by the attending physician (usually it takes from 10 to 14 days).

At the same time, NSAIDs, antifungal agents, nitrofuran derivatives, autohemotherapy and infusion therapy are prescribed. To stimulate the immune system and metabolic processes, the use of vitamins, aloe extract and cocarboxylase is indicated.

If the inflammation of the fallopian tubes is caused by Trichomonas, an anaerobic microflora, then the treatment includes the appointment of metronidazole. Gonorrheal and tuberculous salpingitis are treated in accordance with the standards of therapy for gonorrhea and tuberculosis.

During the recovery period and in chronic salpingitis, the use of physiotherapeutic methods (thermotherapy, hydrotherapy, ultrasound, electrophoresis, magnetotherapy and UHF) is indicated. Acupuncture sessions can be prescribed to relieve pain.

Surgical treatment for salpingitis is extremely rare and only if the patient's condition is extremely severe. Surgical intervention is carried out by laparoscopy. During the operation, the small pelvis is washed with antiseptic solutions, and the adhesions formed are also separated.

For the diagnosis and treatment of inflammation of the fallopian tubes, please contact the AltraVita clinic. There are doctors who have rich and successful experience in dealing with this disease.