Ovarian apoplexy Shymkent

Ovarian apoplexy

Ovarian apoplexy is an acute hemorrhage into the ovarian tissue, accompanied by the rupture of ovarian tissue and bleeding into the abdominal cavity. It is considered an acute emergency gynecological condition. Ovarian apoplexy is more prevalent between the ages of 20 and 36. Among all gynecological pathologies, apoplexy occurs at a rate of 1-3%, meaning it happens with a frequency of 1 in 25-30 thousand women. The recurrence rate of the disease reaches 50-65%. Ovarian apoplexy typically occurs in the second half of the menstrual cycle when the permeability of ovarian vessels increases, leading to an accumulation of blood in the ovary.


Predisposing factors to apoplexy include pelvic inflammatory processes (adnexitis), prolonged use of anticoagulant medications, and hormonal disorders.


The disease begins with the onset of acute severe pain in the lower abdomen. Typically, the pain occurs more frequently after physical exertion or during sexual intercourse, but it can also manifest at rest. The pain is usually localized on the side of the affected ovary. Subsequently, the clinical presentation of the disease is influenced by bleeding into the abdominal cavity: the intensity of pain somewhat decreases, and the pain may extend to the entire abdomen. Other symptoms may include increasing weakness, nausea, and dizziness. Additionally, there may be an increase in pulse rate, and a decrease in blood pressure could be observed.


The diagnosis of apoplexy is comprehensive. In addition to gathering complaints, medical history, and a gynecological examination, ultrasound is imperative. Ultrasound can reveal free fluid in the abdominal cavity and changes in the structure of the ovary. A general blood test may show a decrease in the level of hemoglobin and the number of red blood cells.


Treatment in most cases is surgical. In the presence of bleeding from a ruptured ovary, urgent surgical intervention is indicated, which can be performed through laparoscopy or laparotomy. The surgical procedures may involve suturing the ovary (or its removal in cases of a significant rupture) to stop the bleeding. Conservative treatment is only considered in rare cases, specifically when there is hemorrhage into the ovarian tissue without bleeding into the abdominal cavity. Patients suspected of ovarian apoplexy should be promptly taken to a round-the-clock multidisciplinary hospital.

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