What does ovarian corpus luteum rupture mean? How to treat it?

Ovarian corpus luteum rupture is a common gynecological disease in women. For female friends, their understanding of ovarian corpus luteum rupture is not particularly clear, so the following is a detailed introduction for everyone.

What does ovarian corpus luteum rupture mean?

During the development of the corpus luteum, the small blood vessels on the surface of the ovary may be damaged by chance, causing internal bleeding in the corpus luteum, leading to increased internal pressure and rupture, which is called ovarian corpus luteum rupture. Severe cases can cause massive intra-abdominal bleeding, which is ovarian rupture.

Ovarian corpus luteum rupture is a gynecological emergency. The time of ovarian rupture has a certain relationship with the menstrual cycle and can be used as the main basis for diagnosis. About 80% of ovarian ruptures are caused by rupture of the corpus luteum or corpus luteum cyst, so it usually occurs after ovulation, mostly in the last week of the menstrual cycle, and occasionally on the first or second day of the menstrual period. In a small number of cases, the disease is caused by follicle rupture, which often occurs in mature follicles, so the onset is generally between the 20th and 26th day of the menstrual cycle.

Patients with ovarian rupture generally have no history of ovarian dysfunction, and most of them have ovulatory cycles. Abdominal tenderness is not obvious, but bimanual examination reveals very obvious pelvic tenderness, which, combined with the menstrual history, can usually lead to a diagnosis. If there is a history of post-coital onset, the possibility is greater. We retrospectively analyzed the sonograms of 20 cases of ovarian corpus luteum rupture and hemorrhage diagnosed by ultrasound and confirmed by surgery and pathology in our hospital from 1999 to 2001, as well as 2 cases misdiagnosed as ovarian corpus luteum rupture and hemorrhage, in order to provide assistance for their correct diagnosis and differentiation.

How to treat it?

The treatment principles are basically the same as those for ectopic pregnancy, and there are two methods: conservative and surgical. However, since the chance of recurrent bleeding is smaller, once the condition stabilizes, conservative treatment is more likely to be successful under close observation. If the diagnosis of this disease is confirmed by laparoscopy, conservative treatment will be more confident. The surgical method is laparotomy to stop bleeding, and the ruptured corpus luteum often needs to be removed and then sutured. During the operation, accumulated blood is removed and fresh internal bleeding can be autotransfused to save blood.

In this group, conservative treatment was successful in 20 cases, using anti-inflammatory and anti-cordial drugs, observing abdominal pain, and monitoring pelvic effusion and changes in adnexal masses with B-ultrasound.

Pay attention to self-protection in the later stages of menstruation and avoid some triggering factors. Because corpus luteum rupture can gradually coagulate and stop bleeding after a single bleeding, the chance of recurrence is low. Doctors should be aware of conservative treatment, diagnose and treat early, and reduce the chance of surgery. However, for patients with acute onset, severe clinical symptoms, excessive internal bleeding or ectopic pregnancy, early surgery can reduce blood loss, which is beneficial to the patient's health recovery. During the operation, the ovarian function can be preserved as much as possible, which is beneficial to the patient's physical and mental health.