It's another year of "5.20", and on this special day to express love, the emergency room of the hospital often encounters patients who have problems due to "applause for love".
"5.20" encountered a rupture of the corpus luteum
In the early hours of the morning, a young newlywed couple came to the emergency room, the woman was 25 years old, her face was pale, holding her stomach, and the man looked frightened and helped the girl into the emergency room. The medical staff immediately examined the woman, and at the same time asked for a detailed medical history, and learned that the two young people came to Nanjing on their honeymoon trip, enjoyed the beautiful scenery of the mountains and rivers during the day, and traveled ten miles of Qinhuai lights at night, especially happy, and were in a good mood and good atmosphere after returning to the hotel. But the two felt embarrassed to come to the hospital, and after another hour of grinding, the woman's abdominal pain became more and more intense, she began to feel dizzy, and vomited once, so she hurried to Nanjing Maternal and Child Health Hospital for treatment.
After B-ultrasound examination, the woman's right ovary was significantly enlarged with the possibility of luteal hematoma and abdominopelvic hemorrhage, and she was diagnosed with rupture of the corpus luteum. Single-port laparoscopic surgery was performed in the emergency department to stop the bleeding, and the intra-abdominal bleeding had reached 900ml. After the operation, the couple had palpitations and were glad to have finally come to the hospital.
The woman was very satisfied that the single-port laparoscope was the only surgery in which the incision was hidden at the navel, and the surgical scar was not visible in the abdomen. At the same time, the doctor also reminded the husband and wife that love can be intense and passionate, or gentle and delicate, and they must pay attention to gentleness when having sex in the second half of menstruation in the future to prevent repeating the mistakes of the past.
What is the rupture of the corpus luteum?
Ge Lili, director of the Department of Gynecology of Nanjing Maternal and Child Health Hospital, introduced that the rupture of the corpus luteum is one of the three major acute abdomen in gynecology, especially in young women.
What is the corpus luteum? During each menstrual cycle in a woman, follicles in the ovaries mature and ovulate. After ovulation, the follicular fluid will flow out, the follicle wall will collapse, at this time, a large number of capillaries and connective tissue will enter the position of the follicle collapse, fill the vacancy of the egg cell, and differentiate into a large volume, capillary-rich cell mass under the action of luteinizing hormone, which is light or dark yellow under the action of different concentrations of carotene, so it is called the corpus luteum.
7~8 days after ovulation, the volume and function of the corpus luteum reach its peak, with a diameter of about 1~2 cm. If the egg is not successfully fertilized, the corpus luteum begins to degenerate 9~10 days after ovulation, and remains until two weeks after ovulation, after which it atrophies, and the next menstrual period will come on time. Due to the large tension, small elasticity and abundant blood vessels of the corpus luteum located on the surface of the ovary, when the blood vessels in the corpus luteum rupture due to internal or external forces, the bleeding cannot be stopped by itself, and the internal pressure of the corpus luteum gradually increases, which can cause the rupture and bleeding of the corpus luteum of the ovary.
Why does the corpus luteum rupture?
According to Greely, there are two main reasons for the rupture of the corpus luteum:
1. Spontaneous rupture mostly occurs in women of childbearing age. During the formation of the corpus luteum, the corpus luteum cyst has large surface tension, small elasticity, and abundant blood vessels, and spontaneous rupture of the corpus luteum may occur when the pressure in the corpus luteum increases to a certain extent, but this is relatively rare. In addition, if there is abnormal coagulation function, such as hemophilia, idiopathic thrombocytopenia and other diseases, it is also easy to cause spontaneous bleeding in the corpus luteum, and it is impossible to coagulate, resulting in an increase in the pressure in the corpus luteum and the rupture of the corpus luteum.
2. External factors The main factors are increased abdominal pressure and improper sexual life. There are generally two types of conditions that lead to increased abdominal pressure: one is forced coughing, defecation and long-term urine holding, etc., when the pressure in the abdominal cavity increases significantly; The second is strenuous exercise and external impact, etc., when the female abdomen is impacted, falling, jumping violently, and running in the luteal period, the intra-abdominal pressure will suddenly rise, so that the mature corpus luteum ruptures.
In addition, simple and rough sex life is the "main force" that induces the rupture of the corpus luteum, during sexual life, the female reproductive organs will naturally expand and congest, the muscle tissue will show spasmodic contractions, and the tension in the corpus luteum will also be forced to rise.
What are the consequences of a ruptured corpus luteum?
Because the rupture of the corpus luteum is in the abdominal cavity, blood flows into the abdominal cavity, causing a range of clinical symptoms. The most prominent manifestation is abdominal pain, which usually begins as pain in one side of the lower abdomen. If the damage to the blood vessels is mild and the bleeding is low, the bleeding usually stops on its own, and the abdominal pain gradually lessens on its own, and the pain disappears over time. If the degree of vascular damage is large, the amount of bleeding is large, and the damaged blood vessel cannot heal itself, the patient will have dizziness, fatigue, palpitations, cold sweats and even shock symptoms, such as sweating, dizziness, blood pressure drop, cold limbs, etc., accompanied by nausea and vomiting, anal distension and other symptoms.
How can I prevent rupture of the corpus luteum?
The corpus luteum generally appears every month, and the rupture of the corpus luteum makes it impossible to prevent it, and Ge Lili reminds us to pay attention to the following 5 points:
1. Every woman should have a general understanding of the basic knowledge of ovaries and learn to calculate the follicular phase, ovulation phase and luteal phase.
2. The luteal phase (especially the week before menstruation) is larger in size and the wall is more fragile, so female friends should pay attention to self-protection, exercise moderately, and it is best not to do strenuous exercise and not to carry out heavy objects.
3. If there is cough, habitual constipation and other diseases, it should be treated in time to prevent it from happening.
4. Once there is lower abdominal pain after activity or exercise, you should stop immediately, rest and seek medical attention in time.
5. Both men and women should be as gentle as possible during intercourse during the luteal phase, and seek medical attention in time if there is lower abdominal pain.
Ge Lili reminds: Women in the second half of the menstrual cycle, especially about a week before the next menstrual cramps, abdominal distention, vague pain and other discomfort to consider the possibility of luteal rupture, especially if there is strenuous exercise, external impact or sexual history, immediately go to the hospital for medical treatment, do not delay treatment.
This article is reviewed by experts
Greely
Head of the Department of Gynecology
Chief physician
Doctor of Medicine
Expert Profile:
Youth member of the Obstetrics and Gynecology Branch of Jiangsu Medical Association, member of the Gynecological Tumor Prevention and Treatment Professional Committee of China Eugenics Association, engaged in clinical, teaching and scientific research in obstetrics and gynecology for nearly 20 years, the main research direction: diagnosis and treatment of benign and malignant gynecological tumors and endometriosis, good at minimally invasive surgical treatment of various gynecological diseases. He has undertaken a number of global multi-center drug clinical trials and device clinical trials, published many SCI papers in the direction of gynecological malignant tumors, and is responsible for a number of topics in the direction of various gynecological malignant tumors at all levels.
Professional Expertise:
He specializes in surgery, chemotherapy and whole-process management of various diseases such as cervical cancer, endometrial cancer, ovarian cancer, malignant molar pregnancy, choriocarcinoma, etc. He specializes in minimally invasive surgical treatment and postoperative management of ovarian tumors, ovarian chocolate cysts, uterine fibroids, adenomyosis, etc., prevention of recurrence, as well as diagnosis and treatment of precancerous lesions such as cervical intraepithelial neoplasia and endometrial dysplasia.
Clinic Hours:
Specialist clinic on Monday morning
Tuesday mornings Specialist Clinic
Source: Nanjing Maternal and Child Health Hospital
Correspondent: Cai Xiaojie
Editor: Hu Ying
Reviewer: Chen Shirui
Issued: Daley Red