tubal malformation
Introduction
Introduction to fallopian tube malformation The fallopian tube is developed from a separate segment of the upper end of the two renal tubes. Therefore, it is much less likely to be deformed than the uterus, cervix and vagina. Despite this, the anomalies of thefallopian tube can be seen occasionally in the clinic, and once a certain complication occurs, the sinister pregnancy, such as an ectopic pregnancy, can lead to death if not diagnosed. Although the fallopian tube malformation is rare, there are many types. Tubal malformations can be divided into two categories: malformations (absence or hypoplasia) caused by developmental disorders and repeated malformations (parallel fallopian tubes, etc.). Malformations of the fallopian tubes can only be partially explained by histology. basic knowledge Sickness ratio: 0.0001% Susceptible people: women Mode of infection: non-infectious Complications: ectopic pregnancy
Cause
Causes of tubal malformation
Disease factors (75%):
There are many reasons for tubal malformation. Although it can be caused by tubal dysplasia, endometrial transposition in the fallopian tube or polyp in the fallopian tube, the most important cause is caused by inflammation of the fallopian tube. There are two common types of inflammation: one Is a purulent fallopian tube malformation, mostly due to childbirth, abortion or inflammation after surgery, but also due to inflammation of adjacent organs, such as appendicitis, peritonitis. The other is tuberculous tubal malformation, mostly due to the spread of tuberculosis and peritoneal tuberculosis.
Physiological factors (15%):
Congenital malformations of the fallopian tube are not easy to be found. The first reason is that they are often neglected with congenital malformations of the reproductive tract, and the second is deep in the pelvic side. Commonly used diagnostic methods, uterine fallopian tube angiography found unilateral fallopian tube or double fallopian tube.
Prevention
Tubal malformation prevention
1. When women are sexually active, they should pay attention to the personal hygiene of themselves and their sexual partners. Before the trip, it is necessary to clean the external genitalia of both men and women to prevent the smooth invasion of germs. When women have bleeding symptoms in the vagina, they should refrain from sexual life.
2, women should pay attention to their vulva hygiene and personal hygiene; pay attention to prevent infections from sanitary ware and toilets.
3, the majority of women should pay attention to their own nutrition and health, strengthen menstrual period, after abortion, after childbirth nutrition; enhance their physical fitness, increase resistance, immunity, reduce the chance of illness.
4, the need for artificial abortion, childbirth, access to intrauterine device, and other official cavity surgery, should be strictly disinfected, to avoid the bacteria into the vagina and uterus by surgery, artificial infection.
5. Female patients with acute tubal injury should take a semi-recumbent rest to prevent and limit the flow of inflammatory fluids due to changes in body position. Eat high-nutrient, digestible, vitamin-rich foods.
6. Once a woman has an attachment disease, she should abide by the principle of treatment, adopt a positive attitude, thoroughly treat, and control the condition as soon as possible to prevent chronic changes.
Complication
Tubal malformation complications Complications, ectopic pregnancy
1, like tubal hypoplasia, closed trigeminal, congenital closure or umbrella is completely connected with a fibrous cord and stretched to the uterus. This malformation often leads to infertility or ectopic pregnancy, and it is difficult to repair or reconstruct through surgery.
2. The segmental loss of the middle part of the fallopian tube is like the case of tubal sterilization. The fibrous tissue of the missing segment is microscopic. If there is a uterine malformation, the pregnancy rate will be greatly reduced, and these fallopian tube forming operations are prone to ectopic pregnancy after surgery.
3, the fallopian tube shortened, curled or capsular bag-like deformities often occur in the mother's pregnancy with some preparations of medical history.
Symptom
Symptoms of tubal malformation Common symptoms Irregular menstruation Female infertility Menstrual volume
First, the absence of the fallopian tube: the cause of the absence of the fallopian tube is not clear, such as the absence of unilateral fallopian tube, the entire secondary renal tube on this side is not developed, so the ipsilateral uterus, cervix can not form, mainly as A single-horned uterus and fallopian tube produced by the development of the contralateral renal tube.
Second, tubal hypoplasia: the symptoms of tubal hypoplasia are the true fallopian tube, the cord-shaped fallopian tube and the poorly developed fallopian tube, which are all inhibited or hindered by the degree of initial development of the fallopian tube. Happening.
Third, the fallopian tube diverticulum: the fallopian tube diverticulum appears in the ampulla of the fallopian tube, the cause is not very clear. Pregnant eggs are easy to grow here, and there is a miscarriage or rupture of the fallopian tube ampulla.
Fourth, patients with tubal malformation will have symptoms of unilateral tubal deficiencies, usually with the absence of the same side uterus.
Fifth, female patients may also have bilateral abscesses, which may occur along with uterine insufficiency and belong to a uterine malformation complication.
Sixth, tubal malformation can also appear as a parasitic fallopian tube phenomenon, is a symptom of abnormal tubal development, very common, mainly because there is a small fallopian tube next to the normal fallopian tube.
Seventh, tubal malformation can also cause tubal hypoplasia or atresia, once this phenomenon occurs, it will lead to female infertility and ectopic pregnancy.
Eighth, female patients may also have a lack of a segment of the fallopian tube, greatly reducing the chance of pregnancy.
Examine
Tubal malformation examination
1, fallopian tube ventilation test
The fallopian tube ventilation test, also known as the Rubin test, injects gas (carbon dioxide or oxygen) into the uterine cavity through the catheter, and determines whether the fallopian tube is unobstructed according to the insufflation pressure, lower abdomen auscultation, patient perception, and abdominal fluoroscopy. The correct rate of diagnosis is only 45.0%-50.0%, and there is a potential hazard of airway embolism. It is not suitable as a method for detecting tubal patency, and has been gradually replaced by other methods.
2, fallopian tube fluid test
The tubal fluid test is to inject liquid into the uterine cavity through the catheter, and determine whether the fallopian tube is unobstructed according to the size of the infusion resistance, the presence or absence of reflux, the amount of fluid injected, and the patient's sensation. Because the tubal fluid is easy to handle, requires no special equipment, and has low cost, it is widely used. However, the disadvantage of tubal fluid is that it can not intuitively understand the patency and obstruction of the uterine cavity and fallopian tube lumen, and has the possibility of causing or aggravating the hydrosalpinx.
3, X-ray hysterosalpingography
X-ray hysterosalpingography (x-rayHSG) was injected into the uterine cavity and fallopian tube through the catheter, X-ray fluoroscopy and radiography, according to the contrast agent in the fallopian tube and pelvic development. Fallopian tube angiography can provide the size of the cervical canal, uterine cavity, shape and uterus. When there is no obstruction or paralysis of the fallopian tube, the fallopian tube angiography can show the length, diameter, shape and folding of the fallopian tube. HSG can not only clear the fallopian tube. Whether it is patency and obstruction can also make a diagnosis of the internal structure of the fallopian tube. Selective salpingography has minimal damage, and fallopian tube angiography can correctly diagnose tubal obstruction (especially proximal obstruction).
4, uterine fallopian tube ultrasound
Uterine fallopian tube ultrasonography (HSUG) is simple, non-invasive, and clear in image. In the early 1980s, the fallopian tube patency test under ultrasound was widely concerned by gynaecologists. In the late 1980s and early 1990s, the development of ultrasound diagnostic contrast agents, Application, and the promotion of color Doppler ultrasound diagnostic apparatus (CDI), the accuracy of the evaluation of tubal patency under ultrasound is greatly improved. Practice has proved that ultrasound hysterosalpingography is simple, non-invasive, with fewer side effects and higher correctness; Ultrasound is favored by obstetricians and gynaecologists because of its clear pelvic scanning effect and the fact that the examinee does not need to fill the bladder. Many reproductive centers use it as a routine check for infertile women to monitor follicular development and egg retrieval. Therefore, vaginal ultrasound color Doppler hysterosalpingography is more advantageous.
Diagnosis
Diagnosis and differentiation of tubal malformation
Since the fallopian tube is located in the pelvic cavity, some pathological changes of the fallopian tube cannot be diagnosed by general examination. Because of its non-specific clinical symptoms and gynecological palpation, laboratory tests are also non-specific, so in clinical, tubal malformations are often due to infertility, uterine malformation, etc. for laparoscopic or exploratory laparotomy, or abortion due to ectopic pregnancy It was diagnosed only when it was ruptured.
