Pertubatsiya fallopian tubes - Causes, Symptoms and Treatment .MF .
Pertubatsiya (Latin per- through + Anat tuba [uterina] fallopian tube; blowing a synonym of the fallopian tubes..) - A method of study of tubal patency by introducing them through the cavity of the uterus carbon dioxide, air or oxygen.It is used mainly to determine the cause of infertility.
Contraindications to pertubatsii are:
general or local infectious process;
III-IV vaginal cleanness;
bleeding from the cervical canal;
increased ESR and increase white blood cell count.
Pertubatsiyu not recommended earlier than 2 months after the mud and 4 months after the exacerbation of the inflammatory process in genitals.
Before pertubatsiey examine the contents of the vagina (swab), conduct a bimanual (vagina to bryushnostenochnoe) study, examination of the vagina and cervix using a vaginal mirrors.
Pertubatsiyu performed on an outpatient basis (in the antenatal clinic or polyclinic) in the first phase of the menstrual cycle, asDuring this period lining of the uterus and fallopian tubes thin and does not in
woman is on the gynecological chair in the position for vaginal operations.The cervix is exposed with the help of vaginal mirrors, and after appropriate treatment fixed bullet forceps, then the uterus is introduced special tip or cannula Schultze so as to tightly close the cervical canal (not to be before the procedure to probe the uterus in order to prevent injuries and gas into the blood vessels).Gas is introduced into the uterine cavity under pressure gradually less than 200 mm Hg.Art.(In excess of this level can lead to rupture of the fallopian rude).
To evaluate tubal patency is necessary to take into account the results of auscultation of the abdomen and a sense of a woman during pertubatsii.If you receive gas from the mother is rude to the abdominal cavity is defined by a characteristic auscultation tube noise.Subjective symptoms gas into the abdominal cavity is frenikus-symptom - pain in the right supraclavicular region, due to stimulation of the phrenic nerve endings gas.In case of violation of the Fallopian tubes there are pains in the lower abdomen.
most informative pertubatsiya, where with the help of special devices writing fluctuations of gas pressure in the system are recorded, reflecting the permeability and contractile activity of uterine tubes - kimograficheskaya pertubatsiya.Given kimograficheskih data identify several choices tubal condition:
freely passable Fallopian tubes: The pressure at which gas begins to flow into the peritoneal cavity (maximum pressure) is equal to 60-90 mm Hg.Art .: peristalsis of the fallopian tubes is good;auscultation tube noise is determined on both sides of the abdomen;frenikus-symptom appears after administration of 70-100 ml of gas, if the patient took a vertical position.
Spasm of the fallopian tubes: the gas pressure remains at the same numbers (100-140 mm Hg..) For a long time, a sharp drop in its note after the introduction of muscle relaxants;peristalsis of the fallopian tubes and frenikus-symptom appear after the gas pressure drop.
atony tubal: gas enters freely into the abdominal cavity, its maximum pressure is lower than normal (about 40 mm Hg..);peristalsis of the fallopian tubes sluggish;frenikus-symptom appears quickly and is well marked.
Difficult patency (stenosis) of the fallopian tubes: high maximum pressure (160-180 mm Hg..), Which is gradually reduced, but the minimum pressure at which the pipe is maintained patency remains high (above 100 mm Hg..);peristalsis of the fallopian tubes almost not determined;frenikus-symptom weakly expressed.
obstruction of the fallopian tubes: the gas pressure continuously increases, reaching 160-200 mm Hg.Article .;peristalsis of the fallopian tubes is absent;auscultation abdominal pipe noise is not determined;during pertubatsii there are pains in the lower abdomen, frenikus-negative symptom.
Especially valuable information about the state of the fallopian tubes can be obtained by comparing the results kimograficheskoypertubatsii and metrosalpingography.
After pertubatsii woman should be under the supervision of medical staff for 1-2 hours.
Complications (exacerbation of inflammation in the pelvic organs, rupture of the fallopian tubes, air embolism) are rare for non-compliance and violation of conditions provedeniyapertubatsii its technology.