The course of pregnancy, childbirth and the postpartum period in patients after ovarian apoplexy

Abstract

The objective: to study the features of the course of pregnancy, childbirth and the postpartum period in women with a history of surgical treatment of ovarian apoplexy.Materials and methods. The study involved 62 women in labor (main group, n=62), who were operated on for ovarian apoplexy before pregnancy, and 60 patients in the control group (n=60), who did not have this pathology in the anamnesis. The average age of women was 26,1±2,3 years, the time interval from an episode of ovarian apoplexy to pregnancy was 5,44±2,7 years. Re-apoplexy was observed in 2 cases (3,22%).Results. The study found that the main complication in the first trimester of pregnancy was reproductive loss, mainly in the form of a stillborn pregnancy. In the early stages of gestation, the threat of abortion was 3 times more often observed in the main group than in the control group. In the second trimester draws attention to several facts of complications that are characteristic of patients in the main group: the widespread prevalence of acute or chronic infectious pathology in the acute stage (51,6% vs. 11,7% in the control group), the development of preeclampsia 2 times more often among pregnant women with ovarian apoplexy (38,7% vs. 20,0%), as well as mild anemia (40,3% vs. 21,6%).The results of the study indicate a high frequency of premature ejaculation of amniotic fluid in pregnant women with ovarian apoplexy (29,0% vs. 13,3%), rapid labor (16,1% vs. 1,7%), umbilical cord entanglement (33,9% vs. 15,0%), hypotonic bleeding in the early postpartum period (14,5% vs. 1,67%). The frequency of cesarean section did not differ significantly in both groups (p>0,05). The assessment of newborns on the Apgar scale had no statistically significant differences.Conclusion. Pregnant women who have a history of surgical treatment of ovarian apoplexy are at risk for developing early miscarriage, complicated gestation, childbirth and the postpartum period. Analysis of the reproductive function of women in the study groups reflected the problems of gestation mainly in the early stages in the form of reproductive loss or symptoms of miscarriage, in the late stages of pregnancy complications were mainly due to extragenital pathology. The data obtained during the study in practice should contribute to the development of rehabilitation measures and pre-pregnancy training, which are aimed at restoring reproductive health and prevention of complications of pregnancy and childbirth in women at risk.