A rupture of the fallopian tube is an acutely life-threatening complication that usually occurs in connection with an ectopic pregnancy. It requires emergency surgery.
What is a fallopian tube rupture?
According to polyhobbies, a rupture of a fallopian tube (tuba uterina) is called a rupture of the fallopian tube. A fallopian tube rupture almost always occurs as a result of an ectopic pregnancy (tubal pregnancy).
This accounts for 96% of all extrauterine pregnancies. Depending on which section of the fallopian tube the fruit is implanted, a distinction is made between infundibular, ampullary, isthmic and interstitial ectopic pregnancies.
The isthmic and interstitial variants are the most life-threatening, as there is a particularly dense blood supply in these sections. In the event of a fallopian tube rupture, there is a risk of rapid and high blood loss.
Causes
The fallopian tube is a 10-15 cm long muscular tube that transports the egg from the ovary to the uterus. The transport takes place on the one hand by muscular peristalsis, on the other hand by rhythmically beating cilia that line the fallopian tubes and maintain a constant flow of fluid towards the uterus.
The egg normally takes 3-5 days to migrate through the fallopian tube. Since it is only capable of fertilization during the first 24 hours after ovulation, fertilization must take place in the fallopian tube. About 6 days after fertilization, the egg cell becomes embedded in the mucous membrane that surrounds it – regardless of whether it has already reached the uterus.
Is the passage through the fallopian tube disrupted or delayed – e.g. B. by constrictions, adhesions, adhesions or a loss of function of the cilia – the fallopian tube becomes the home of the growing fruit. As the growth progresses, there is a threat of a fallopian tube rupture.
Symptoms, ailments & signs
A fallopian tube rupture is initially symptom-free. Initially, the ectopic pregnancy is like a normal pregnancy, and often it comes before the first complaints to a natural abortion. If the outcome is less positive, the growing embryo leads to a stretching of the fallopian tube.
As a result, recurring, mostly unilateral pelvic pain occurs from the fifth to sixth week of pregnancy. In the further course, the hormone production decreases. This can lead to spotting and menstrual cramps. If no medical examination is carried out by then at the latest, the actual fallopian tube rupture finally occurs.
The main symptoms include sudden pelvic pain and cramps in the abdomen. The internal blood loss causes hypovolemic shock, which manifests itself in sweating, paleness and a drop in blood pressure. At the same time, a circulatory collapse can occur. An untreated fallopian tube rupture can also lead to inflammation of the peritoneum.
Pain in the area of the flanks, defensive tension when palpating the abdomen and gastrointestinal complaints can also arise. If left untreated, the fallopian tube rupture can cause discomfort when urinating. Affected women usually feel a strong feeling of illness, which increases in intensity as the disease progresses and greatly reduces their well-being. These symptoms and signs can be used to clearly diagnose a fallopian tube rupture.
Diagnosis & course
In the first few weeks, an ectopic pregnancy is usually normal and shows the signs of a normal pregnancy. It is not uncommon for a natural abortion (tubal abortion) to occur before the ectopic pregnancy can become dangerous for the mother.
If this is not the case, however, the growing embryo continues to expand the fallopian tube. Affected women then feel from the 5th to 6th Recurring, unilateral pelvic pain during the week of pregnancy. Due to a lack of space, the 6th-7th SSW the growth of the embryo: This reduces the production of the hormone ß-HCG, which in turn lowers the mother’s progesterone level and causes spotting.
If the person concerned does not seek medical treatment despite these warnings, the fallopian tube will actually rupture at some point. The main symptoms are sudden, massive pelvic pain, often in combination with immune tension. The internal blood loss leads to hypovolemic shock – recognizable by paleness, drop in blood pressure, increased heart rate and cold sweat.
In terms of anamnesty, the combination of pain and spotting after several weeks of previous amenorrhea provides crucial information. Laboratory diagnostics and palpation examinations harden the suspicion. The fallopian tube rupture is clearly demonstrated by an ultrasound examination.
The fallopian tube is a muscular tube about four to fifteen centimeters long that connects the ovaries to the uterus. A rupture of the fallopian tube is almost always the result of an ectopic pregnancy. Depending on where the fertilized egg cell is implanted, a distinction is made between infundibular, ampullary, isthmic and interstitial ectopic pregnancies.
The Istrian and interstitial ectopic pregnancies are particularly dangerous because they are located in sections that have a particularly dense blood supply. If the fallopian tube ruptures, there is therefore a particularly high level of blood loss within a very short time. In these cases, the patient’s life is in acute danger.
Complications
An ectopic pregnancy in the Istrian section is accompanied by a number of other complications. Usually the fallopian tube is opened lengthways and the fertilized egg is removed with a spoon or a jet of water. The fallopian tube can usually be preserved with this procedure.
In the case of ectopic pregnancies that are located in the isthmic section, however, it is usually not possible to preserve the fallopian tube. In the case of an isthmic ectopic pregnancy, it is imperative to remove all trophoblastic tissue from the abdomen, otherwise the risk of recurrence is extremely high. For the patient, a rupture of the fallopian tube of this type is therefore always associated with greatly reduced fertility. In addition, there is a significant increase in the risk that the patient will have another ectopic pregnancy in the future.
When should you go to the doctor?
If you miss your period and experience unusual abdominal pain, nausea and vomiting, a doctor should be consulted. A fallopian tube rupture is a medical emergency and requires immediate medical attention. In the event of a specific suspicion or a mere discomfort after unprotected sexual intercourse, it is best to contact the gynecologist directly.
Should further symptoms become noticeable, the nearest clinic must be visited quickly. In particular, signs of circulatory shock – freezing, pale face, increased pulse – urgently need to be clarified. Likewise, symptoms of peritonitis and other ailments that significantly impair wellbeing. In principle, an emergency doctor should be called if there are signs of advanced fallopian tube rupture.
Until this is on site, the woman concerned should lie down and, if possible, not move any more. First aid measures must be provided in the event of impaired consciousness or fainting. After the initial treatment, regular check-ups with the gynecologist are indicated. They can monitor the healing process and check whether the ectopic pregnancy has resulted in reduced fertility or other long-term damage.
Treatment & Therapy
A ruptured fallopian tube must be treated quickly, otherwise the patient is at risk of bleeding to death. The emergency operation is minimally invasive in 90% of cases by today laparoscopy done (laparoscopy).
The surgical procedure depends on the one hand on the location and extent of the ectopic pregnancy and on the other hand on whether the patient’s family planning has already been completed. If this is the case, the affected fallopian tube is completely removed (salpingectomy). Alternatively, an attempt can be made to preserve the fallopian tube.
In this case, the fallopian tube is split lengthways and the fruit is either extracted with spoon tongs or rinsed out with a jet of water. In the case of an ectopic pregnancy in the isthmic section, a tube-conserving procedure is usually not possible. Regardless of the type of surgery, it is essential to remove any trophoblast tissue from the abdominal cavity, otherwise recurrences may occur.
With the tube-conserving procedure, there is always a relatively high risk of recurrence of 30%. In addition, after a fallopian tube rupture with a preserved fallopian tube, there is always a significantly increased risk of having another ectopic pregnancy.
Outlook & forecast
A ruptured fallopian tube must be treated immediately by an emergency doctor to ensure the patient’s survival. If the emergency operation takes place on time, there is a possibility of recovery. Without immediate medical care, the mother-to-be can become life-threatening.
The fallopian tube has ruptured as a result of an existing ectopic pregnancy and can lead to the death of those affected by bleeding to death internally. If the fallopian tube is severely damaged, it must be completely removed during the operation. This leads to an infertility patient. If the fallopian tube can be preserved and the damage repaired, the unfavorable prognosis improves. After a few weeks of healing, the patient can be discharged from treatment.
If the outcome is favorable, the patient can become pregnant again and give birth to a healthy child. However, it must be taken into account that a new pregnancy due to the incident is associated with an increased risk of another ectopic pregnancy.
Despite the fact that the fallopian tube is preserved, there is no certainty that the existing desire for pregnancy can be realized. The rupture of the fallopian tubes can trigger mental disorders. This is especially true for women with an increased need to father offspring. The loss of the fetus leads to emotional problems for many women, which must be taken into account as the process progresses.
Prevention
A rupture of the fallopian tubes can primarily be avoided by recognizing and terminating the previous ectopic pregnancy in good time. An early intervention can even be done purely with medication. Therefore, women of childbearing potential should consult a doctor immediately if they notice spotting and / or pain after several weeks of amenorrhea.
Aftercare
In most cases, the follow-up measures for a fallopian tube rupture are very limited. It is a serious complication that usually needs to be treated immediately by a doctor. If the fallopian tube rupture is not treated, severe discomfort can arise, most of which cannot be treated.
Therefore, a very early diagnosis and subsequent treatment of the disease is in the foreground in this disease. In most cases, if a fallopian tube ruptures, surgery is performed. Depending on the severity of the symptoms, the fallopian tubes can then be completely removed.
After the procedure, the person affected should definitely rest and take care of their body. In any case, bed rest is to be observed, whereby stressful and strenuous activities are to be avoided. Since the fallopian tube rupture can also lead to the formation of a tumor, regular examinations should be carried out to prevent this even after successful treatment.
In many cases, the person affected depends on the help and support of friends and acquaintances. This means that psychological complaints or depressive moods can also be treated. However, a visit to a psychologist can also be very useful.
You can do that yourself
A ruptured fallopian tube is not a case for self-treatment. Since a life-threatening condition can arise quickly, the emergency call should be made immediately. An emergency operation is carried out directly in the hospital. If the person concerned or others involved act quickly, the chances of recovery are very good. Self-treatment measures can only be carried out postoperatively.
This includes physical restraint and avoidance of other stress- causing factors. Sexual intercourse should also be avoided in the first few weeks. Due to the mostly minimally invasive operation, the patients recover very quickly. Even if this operation is a minor procedure, the anesthesia and inflammation process put a lot of strain on the body.
Above all, the digestive tract and metabolism should be reactivated. Conducive for the healing process, therefore, walks in the fresh air, are sufficient hydration and recording vital and mineral-rich foods.
The psychological stress should not be neglected either. The rupture usually occurs in connection with an ectopic pregnancy. Thus, an existing desire to have children may not be realized or the chances of getting pregnant again are reduced. Accompanying psychotherapy and relaxation methods that are easy to learn by yourself could support the recovery process holistically. In the event of a new pregnancy, the risk of a repeat ectopic pregnancy is increased, so the gynecologist in charge of the treatment should be checked at shorter intervals.
