Monitoring of a pregnant woman is carried out from the first days when she registered at the clinic. It is possible that after an ultrasound examination, the doctor sees fluid in the retrouterine space, although this should not be the case. Is it dangerous for the fetus and expectant mother? By the way, this trouble can also manifest itself in those who are not expecting the birth of a child. Let's try to find the answer to this question.
The retrouterine space, which doctors call Douglas space, in in good condition represents a closed cavity located behind the uterus and limited by the peritoneum. Free fluid usually accumulates in the lowest recess of this cavity, when viewed relative to abdominal cavity.
Follow own health necessary even in cases where no obvious reasons for concern. Regular visits to the gynecologist are mandatory; ignoring visits to him is unforgivable frivolity for women at any age.
The female condition can be considered normal in cases where the retrouterine space does not contain fluid. But there are times when a little liquid may be present and not pose a threat. women's health. The cyclical processes occurring in the body of every woman are “to blame.”
- The reflux of blood into the peritoneal cavity during menstrual cycle. This is absolutely not dangerous - during menstruation, the endometrium, along with the secreted menstrual blood, “moves” to the abdominal area.
- Ovulation, in which the follicle capsule ruptures and the free egg, ready for fertilization, comes out. Not a large number of The fluid released will disappear without treatment after a few days; it will be absorbed.
- Even girls can have fluid in the space behind the uterus. This may be a consequence of premature puberty. But the final diagnosis will be made by the doctor after the necessary examination has been carried out.
The doctor, most often, does not make an immediate diagnosis, leaving some time to monitor the situation. If the fluid has resolved, then this is a sign of the normal completion of the ovulation process.
If the above cases, in which fluid appears in the retrouterine space, do not require special treatment, since they do not pose a danger, then a completely different attitude should be towards the causes caused by diseases. In itself, the presence of fluid is not a disease, but an important symptom of an illness, sometimes very serious.
- Inflammatory processes in the uterine cavity.
- The presence of polyps on the uterus.
- Diseases of organs that are located near the uterus - ovaries, bladder, fallopian tubes. These are pelvioperitonitis, liver diseases, heart or kidney failure. Organs affected by the disease can secrete an exudative substance and, in some diseases, the doctor will find free fluid in the space behind the uterus. With pelvioperitonitis, peritoneal fluid enters the retrouterine space, the amount of which can be very significant.
- After a recent artificial interruption pregnancy - abortion, the possibility of the presence of fluid in the retrouterine space is also possible.
- Ectopic pregnancy. Liquid in in this case- this is blood, the cause of which may be deformation or damage fallopian tube. This is where it is most often attached. ovum, not reaching the uterus.
- Malignant neoplasms in the abdominal cavity or pelvic area. Thus, an ovarian tumor is accompanied by ascites, when fluid accumulates in the peritoneal cavity. To exclude the formation of neoplasms, computed tomography and magnetic resonance imaging may be required. Only with their help can you “see” and diagnose a tumor.
- Anoplexia is ovarian rupture.
- Endometrioid cysts on the ovaries. Cavity formation pathological nature on the surface of the ovaries. This is menstrual blood contained in a membrane of endometrial cells. Due to microperforation of the cyst, blood leaks out. The presence of a cyst is accompanied by a number of additional symptoms: abdominal pain, sometimes very acute, menstrual irregularities, heavy menstruation.
- Purulent salpingitis. Purulent fluid may appear as a result of rupture of the pyosalpinx. Additional symptoms include increased temperature, painful stomach, leukocytosis. There is a high probability of developing diffuse peritonitis and, as a consequence, immediate surgical intervention.
To accurately diagnose the disease that caused fluid to appear in the retrouterine space, a mandatory cytological examination liquids. You also need to be aware of additional symptoms. They are usually present if the fluid is caused by a medical condition.
Although indirect, there are factors that can increase the likelihood of fluid appearing behind the uterus.
Summary
There is no particular cause for concern if fluid is detected in the retrouterine space. But you should not neglect consultation with a doctor who is monitoring the pregnancy - it is better to be safe. Good luck
Fluid behind the uterus may be caused by serious illness. One of which is pelvic inflammation, which often requires hospitalization.
Sometimes during an ultrasound, the doctor detects free fluid in the retrouterine space. Normally there should be no fluid, so it may be evidence of a disease.
Ovulation
The only reason for fluid accumulation without concomitant disease. During the release of a mature egg, the follicle reaches big size and it ruptures to release a mature egg. At this time, it becomes possible for fluid to enter the peritoneum. What causes its accumulation behind the uterus. However qualified specialist will distinguish this case (indicating that ovulation has occurred) from the disease, since the amount of fluid is very small - the norm. After 2 - 3 days it will resolve.
Inflammatory process
The presence of fluid not due to ovulation is associated with inflammation of the following organs:
- fallopian tube;
- ovaries;
- Bladder;
- uterine cavity.
The fluid will not be able to resolve on its own, so it can be observed during each ultrasound examination. To accurately determine the disease, the gynecologist will order additional tests (urine, blood); if they confirm inflammation, antibacterial drugs will be prescribed.
Treatment of the inflammatory process of the pelvic organs should begin immediately after examination by a doctor. At the initial stage of the disease, the doctor may prescribe one or several types of antibiotics. If such treatment is ineffective or for any other reason why oral administration drugs is impossible, the patient must be hospitalized. In the hospital, antibiotics are administered by injection or IV.
With such a disease, there is a need to treat the partner, since it is often the partner who becomes the carrier of the infection. Neglecting its treatment can provoke a recurrence of the disease.
Surgery involves opening the abscess or eliminating perforation. That is, the operation is prescribed in advanced cases, when tissues exhibit large cluster pus. This is necessary to eliminate the abscess before it ruptures and fills the abdominal cavity with pus. If abscesses form on the uterus or ovaries, removal of the affected organ may be prescribed.
Ectopic pregnancy
If the fertilized egg does not reach the uterine cavity, but is implanted into the wall of the tube, an ectopic pregnancy occurs. There is a need to take a hCG test and retake it ultrasonography(vaginal).
But statistics show that an ectopic pregnancy makes itself felt even before an ultrasound reveals free fluid in the retrouterine space. This is explained by the fact that the liquid appears after the pipe ruptures.
Apoplexy occurs if a vessel of the Graafian bladder, ovarian stroma, follicle cyst or corpus luteum and hemorrhage begins in the ovary. Its tissue is destroyed and hemorrhage continues in the abdominal cavity and in the retrouterine space.
When performing an ultrasound, fluid is observed in the retrouterine space. To be more precise, this liquid is blood, often with clots. The serous cover of the uterus is pink, the size is not increased. May be observed in the uterine tubes chronic inflammation in the form of adhesions.
This disease can be caused by tissue disorders and vascular system ovary, which is caused by hyperemia, sclerotic or dilated vessels, inflammatory process, small cystic deformation of the ovary. Heavy bleeding will occur even without big gap(1 cm in diameter).
With apoplexy, the following symptoms are observed:
- pain in the lumbar region and lower abdomen;
- bloody discharge from the vagina, which stops along with the pain;
- general weakness;
- dizziness.
Reasons for the breakup:
- injury;
- sexual intercourse.
Apoplexy is acute illness, which requires urgent medical examination. If there is a suspicion of this disease, urgent hospitalization is indicated. Treatment is aimed at localizing bleeding, restoring ovarian tissue and stabilizing the condition after blood loss.
Acute purulent salpingitis
Acute purulent salpingitis is an acute inflammation of the pelvic organs. An ultrasound examination will show expansion, thickening, and elongation of the fallopian tubes, which are characterized by a decrease in echogenicity. There is an accumulation of free fluid in the rectal uterine cavity.
Symptoms of the disease:
- abdominal pain;
- sensitivity during cervical movement;
- elevated temperature;
- leukocytes more than 10500;
- the presence of pus during puncture of the posterior fornix;
- ESR >15 mm/h.
Treatment of salpingitis is carried out in 3 stages:
- Preparing for surgery.
- Removal of purulent fluid and treatment of the lesion.
- Rehabilitation after surgery.
Before the operation it is docked acute manifestations inflammation, suppress the aggression of microbial pathogens, correct metabolic disorders.
For more effective treatment, if discomfort, pain or symptoms of the disease appear, you should not delay or try to treat yourself with the help of traditional medicine or, even more so, assign yourself medications. Once every six months you need to visit a gynecologist and, if necessary, undergo an ultrasound. initial stage Almost any disease can be treated, so you shouldn’t neglect your health.
Sometimes on an ultrasound, the doctor can say that fluid is visualized in the retrouterine space during ovulation. In most cases, this is a completely natural process, depending on the stage of the menstrual cycle. However, sometimes fluid is visualized not only in the retrouterine space, but also in the abdominal cavity. Often its cause is not ovulation, but various pathologies.
The retrouterine space is located behind the uterus and is limited by the peritoneum. Often liquid accumulates at the bottom. U healthy women The phenomenon is caused by natural causes, but sometimes serious problems occur.
This indicator is determined by. A special sensor is inserted into the cavity, thanks to which all internal organs are displayed on the screen. The doctor can evaluate the structure of the uterus and look at the size of the ovaries. If a substance is missing, it is not visualized.
Find out another way about possible pathologies difficult in this area. In this regard, it is not surprising that before the examination, patients are not aware of the presence of problems.
What happens during and after ovulation
Fluid in the abdominal cavity with – normal process, carried out when the follicle ruptures and the egg is released. Having been released from the capsule, it goes towards the sperm for fertilization. It is ovulatory processes that can cause the appearance of a small amount of the substance.
These actions are cyclical and recorded monthly. They last after the end of menstruation until the end of the first phase. The substance enters the abdominal cavity. There is very little of it in the follicle itself, so fluid behind the uterus after ovulation is normal and should not cause a feeling of anxiety. After a few days it automatically resolves. If other cases arise, then it is necessary to conduct examinations of nearby organs.
Causes of fluid
There are other natural causes which should not cause concern. This is about:
- . When there is discharge, blood may enter the cavity behind the uterus. This occurs because the endometrium moves smoothly into the abdominal cavity;
- period of early puberty.
The patient's health should be monitored for several days. In this case, women often complain of pain in the ovarian area and increased body temperature. If, during repeated screening, fluid was absorbed after ovulation in the pelvis, then everything went well, and when it remains, additional tests are prescribed to identify the problem.
There are factors that explain this phenomenon. Despite the fact that they are considered indirect, you should not turn a blind eye to them:
- bad habits;
- promiscuous sex life;
- past genital surgeries;
- sedentary lifestyle;
- unhealthy diet;
- hormonal imbalance.
Inflammations and their treatment
Often fluid in the retrouterine space occurs due to inflammation of such organs as:
- bladder.
When such diseases are diagnosed, the accumulated substance must be helped to dissolve. After undergoing an ultrasound examination, the doctor will determine the course of treatment. By the way, patients cannot prescribe it for themselves; a doctor’s supervision is required. Drugs are often prescribed antibacterial action. Features of treatment depend on each specific case.
If the disease is found at the initial stage, the gynecologist will probably limit himself to prescribing antibiotics. In the case when the effect of taking medicines is not observed, it is better to resort to injections and droppers.
When the situation is advanced, purulent accumulations form in the tissues. Then surgery is performed. With it, the abscess is opened to prevent it from entering the peritoneum. Otherwise, the consequences may be dire.
It happens that the abscess is located on the uterus or ovaries, and the organs will have to be removed. The carrier of an infectious disease can be a sexual partner. In this regard, the doctor sends him for examination.
Presence of bloody fluid
One of the pathologies is the presence of a large number bloody fluid. It comes from an ovary that has ruptured. In medicine, this disease is called. The disease develops when internal vessels, or him. After its destruction, the substance enters the peritoneum. Often the blood has small clots. All this is accompanied by:
Blood often appears as a result of hard sexual contact, injuries, excessive physical activity, .
What pathologies does he talk about?
Sometimes we are talking about inflammation of the pelvic organs. This disease is called purulent salpingitis. The ultrasound specialist sees the lengthening or expansion of the pipes. The disease is characterized elevated temperature, painful sensations, increased sensitivity.
With this diagnosis, tests show a large number of leukocytes. This needs to be treated strictly surgical intervention. Everything unnecessary is removed acute inflammation surgeons stop, the influence of microbes is suppressed, the lesion is carefully treated, if there are metabolic disorders, they are corrected.
Himself healing process is long lasting. It consists of rehabilitation period, during which the patient’s condition is monitored by a specialized specialist. Periodically tests are taken and screenings are done to see how the body is recovering.
Conclusion
So, fluid in the retrouterine space during ovulation is generally normal. Follicle rupture should not cause concern in a woman. However, when there are more serious symptoms and the ultrasound specialist detects fluid in the retrouterine space, then you should consult a doctor. The cause of the pathology is not considered to be ovulation, but inflammatory processes.
The best form of treatment is timely prevention. In order to identify incipient pathologies in a timely manner, doctors recommend that women be examined by a gynecologist every six months or a year and have an ultrasound of the pelvis. This simple study will help to promptly identify possible violations functioning of the body.
What does fluid in the pelvis mean?
Accumulation biological fluid(blood, exudate) in the body cavity is called effusion. This condition in itself is not an independent disease. Often this is a symptom of a disease, and the effusion does not appear in any way. Only a few women who had fluid in the pelvis on ultrasound complained of severe pain or abdominal discomfort or unusual vaginal discharge.
It is not always necessary to be alarmed when you hear from the ultrasound technician that you have an effusion. Sometimes a small amount of free fluid visualized in the pelvis does not indicate any abnormalities and is a variant of the norm. For example, with a stable menstrual cycle after ovulation, an ultrasound specialist can examine a small amount of the contents of a burst follicle just behind the uterus. Over the course of several days, this phenomenon goes away on its own.
Still, most cases of fluid in the pelvis detected during an ultrasound directly indicate that the woman needs to close attention on the state of your health. If this is the result of the study, the patient is referred to additional diagnostics in order to select appropriate therapy for treatment, because pathology may signal various diseases and states:
- ectopic pregnancy;
- endometriosis;
- rupture of an ovarian cyst;
- purulent salpingitis;
- intra-abdominal bleeding;
- liver damage;
- tumor processes.
In the retrouterine space
If during an ultrasound the doctor detects fluid behind the uterus, and it is not a consequence of ovulation (has not resolved within 2-3 days), he has every reason to suspect that the patient has serious illness and even a life-threatening condition. Such symptoms may occur due to an inflammatory process in:
- ovaries;
- fallopian tubes;
- uterine cavity;
- bladder.
One of the most life-threatening conditions, in which fluid is clearly visible in the retrouterine space and which requires immediate surgery, is ectopic pregnancy. The effusion occurs due to a rupture of the fallopian tube, where the fertilized egg was implanted. As a consequence of this in abdominal space blood penetrates and collects there.
To the list of main diseases internal organs, in which fluid in the pelvis is also visualized on ultrasound, include:
- endometritis;
- endometriosis;
- adnexitis;
- ovarian cyst;
- acute purulent salpingitis;
- internal bleeding caused by injury;
- ascites – accumulation of fluid due to liver pathologies, progression of malignant diseases, etc.
Fluid in the uterus in old age
If we analyze the ultrasound data of postmenopausal women, when interpreting them, specialists often make a diagnosis of serosometer. It indicates that the patient has fluid in the uterine cavity. This condition is a consequence of the fact that inflammatory processes of various origins develop inside the organ: infection, endometriosis, polyps, complications after chronic diseases genitourinary system etc. Serozometra can be suspected if a woman feels pain in the lower abdomen or pain during sexual intercourse.
Often, if during diagnosis a specialist observes fluid in the uterus, it is also visualized in the fallopian tubes. This pathology suggests that in this part reproductive system the normal circulation of blood and lymph is disrupted. With further development, such changes lead to the formation of closed cavities in the pipes, which stretch and thin their walls. Next, adhesions appear, which, if this process is not stopped in time, will quickly spread to all organs of the genitourinary system.
In the ovary in women
A formation with liquid contents that can occur on these organs is called a cyst. The most common reasons such pathology female body is improper functioning of the gonads, hormonal imbalance, insufficient health prevention - hypothermia, untimely treatment chronic inflammatory processes, etc.
The cyst, which contains fluid in the ovary, does not show any symptoms in the first stages of development. Only over time can a woman notice discomfort during sexual intercourse, changes in the nature of menstruation, problems with urination and even an increase in the size of the abdomen, which indicates the growth of the formation. Such long-term manifestation of symptoms once again indicates the importance of regular gynecological examination, because when a cyst ruptures, there is a high probability of complications.
Causes of fluid accumulation
There are several factors that cause effusion. In fact, they are a number of diseases and injuries suffered by the patient. So, with endometriosis, areas of the endometrium that fall outside the organ bleed and fill the cavity behind the uterus with blood. In acute purulent salpingitis, pus and exudate collect in the rectouterine cavity. It is also important to know that in the vessels of the pelvic area, when venous circulation is disrupted, blood accumulates without spilling into the abdominal cavity.
Well, tell me honestly: wouldn’t you be scared if, during an ultrasound, the doctor reports that you have fluid in the retrouterine space? Any patient will immediately have questions. What kind of substance is this? Should she be there and does her presence indicate illness? How dangerous is this? Let's talk about this problem in more detail.
Female anatomy: where is the pouch of Douglas located and where does the fluid come from?
The retrouterine space (or, as doctors call it, the space of Douglas) is a closed cavity that is located behind the uterus and limited by the peritoneal wall. Free fluid in the retrouterine space collects in the lowest recess of this cavity.
What does it mean if fluid is detected in the retrouterine space? Its presence may be related to physiological reasons- then there is nothing to worry about, it will disappear on its own. But in some cases, it still threatens women's health, since its appearance is associated with diseases. If they are not treated in a timely manner, the fluid may penetrate into the peritoneal cavity, which will lead to the development of such dangerous condition like peritonitis.
There is fluid, but no problem
Nothing “like that” should be found in the cavity of Douglas. However, there are a few cases where a small amount of fluid may still be present in the retrouterine space, and this is completely normal and does not require treatment. Blame for its accumulation natural processes that occur in a woman’s body, namely:
- throwing in a small portion of blood during menstruation (which is completely safe). During menstruation, the endometrium, along with menstrual blood, penetrates into the abdominal cavity;
- ovulation. When the capsule of the follicle bursts and the mature egg comes out to meet the sperm, a small part of the fluid that is released can also enter the space behind the uterus. After a couple of days it is absorbed;
- period of puberty in girls and young girls.
If the diagnostician saw fluid in the retrouterine space during an ultrasound examination of the patient (in a small amount), then he does not immediately make a final diagnosis. The doctor watches for some time to see how the situation develops further. If a subsequent ultrasound reveals that the fluid has resolved, this indicates that everything is “going according to plan”: ovulation has completed normally.
If illness is to blame: pathological causes of fluid accumulation
All of the above cases, which lead to the appearance of fluid in the retrouterine space, do not require medical intervention. The causes associated with diseases should be treated completely differently. Of course, fluid is only a symptom and may be a sign of the following health problems:
- inflammation in the uterus. His characteristic symptoms - low-grade fever, pain in the lower abdomen, serous-purulent discharge. Antibiotics will be prescribed for treatment. Symptomatic therapy carried out using painkillers and restoratives;
- polyps on the uterus. The symptoms of this pathology are prolonged and heavy menstruation, bleeding between periods, pain during sexual intercourse, bloody issues after sex, problems with conception. Treatment can be done with hormones, or the polyp can be removed hysteroscopically;
- diseases of organs located adjacent to the uterus. So, with pelvioperitonitis, peritoneal fluid appears in the space behind the uterus. A diseased liver can provoke its appearance. This also happens with cardiac or renal failure. The organs in which the inflammatory process has begun release exudate - it “finds” free space and fills it. Treatment depends on the diagnosis;
- apoplexy (rupture) of the ovary. Leading symptoms - sharp pain and bleeding. Weakness occurs, blood pressure drops, temperature rises, and vomiting occurs once. Surgical treatment (laparoscopy);
- endometriotic cyst on the ovary. Due to microcracks on the surface of the cyst, menstrual blood flows out of its cavity and can enter the retrouterine cavity. The following symptoms help identify this disease: pain in the abdomen, irregular menstrual cycle, heavy bleeding during menstruation. Conservative treatment includes reception hormonal drugs, NSAIDs, painkillers, vitamins and immunomodulators. If it does not produce results, then the cyst is removed (sometimes together with the ovary) or a puncture is performed;
- purulent salpingitis. When the pyosalpinx ruptures, pus enters the abdominal cavity and into the “pocket” located on the back of the uterus. The patient develops additional symptoms- temperature rises, stomach hurts. Leukocytes increase in the blood. Urgent required surgical intervention. Will be deleted excess liquid, and then the woman has to long-term treatment, reducing inflammation, and antimicrobial therapy;
- malignant tumors in the abdominal cavity or pelvis. With a tumor localized on the ovary, ascites often develops and fluid collects in the cavity of Douglas. Complex treatment - surgery, chemotherapy;
- if a woman has had an abortion, then when performing an ultrasound, the doctor can also detect fluid in the described area.
Can fluid be found behind the uterus in a pregnant woman?
Fluid in the retrouterine space during pregnancy is detected only if the fertilized egg has attached to the in the wrong place, that is, with an ectopic pregnancy. This will inevitably lead to wall rupture fallopian tube, which is why the fluid penetrates behind the uterus. But an “incorrect” conception is usually detected (by pain, poor health, spotting) long before excess fluid accumulates.