Reproductive aspects of long-term consequences of ovarian apoplexy

Abstract

The objective: to determine the long-term consequences of surgical treatment of ovarian apoplexy, taking into account the risk factors of this urgent pathology. Materials and methods. The study included 112 women (main group, n=112), who underwent surgery for ovarian apoplexy, and 40 patients in the control group (n=40), who had no history of this pathology. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in age (mean age was 23,6±4,2) and statistically comparable. Results. Based on the analysis of clinical and anamnestic data of patients who underwent surgical treatment of ovarian apoplexy, we identified the main risk factors for this pathology: chronic diseases of the urinary, respiratory and digestive systems, genital infantilism, ovarian retention cysts, chronic salpingo-oophoritis, menstrual disorders by type of hyperpolymenorrhea and/or algodysmenorrhea, family thrombophilic history, bleeding of various localizations in the anamnesis, artificial abortions, weight loss, smoking. Our proposed comprehensive two-stage rehabilitation system included treatment and prevention measures from the acute period of ovarian apoplexy to the time of reproductive function. The first stage of the treatment complex (early postoperative period) helped to eliminate the effects of ovarian injury, pain relief and hypercoagulable changes in the blood coagulation system, improving the quality of life during inpatient treatment. The second stage (2 months after surgery) provided the restoration of ovarian function and balance of the hemostasis system, thus preparing a woman’s reproductive system for future pregnancy and childbirth. In the remote postoperative period, the complex stage of rehabilitation in 23 treated patients resulted in the birth of healthy children and the absence of obstetric complications in 22 of them. Conclusion. Identification and structuring of risk factors for ovarian apoplexy is an important step for comprehensive treatment and prevention of recurrence of this disease. Eliminating or reducing the impact of these factors will help restore the reproductive system and improve quality of life. A comprehensive assessment of the state of the whole organism in the remote postoperative period indicates the need for rehabilitation measures aimed at increasing the natural resistance of the macroorganism and the effective restoration of reproductive function.