Since the introduction of ultrasound, I believe many women of childbearing age are aware of “pelvic effusion”, but is pelvic effusion a sign of pelvic inflammatory disease? Is it necessary to treat pelvic effusion? Here I will give you some knowledge about “pelvic effusion”.
Pelvic effusion
I can’t say whether the chicken or the egg came first, but I can say whether the ultrasound came first or the pelvic fluid came first. Of course, most women should not have pelvic effusion, but is it abnormal to have pelvic effusion?
Production of pelvic fluid
When the body is standing, the pelvis, as the lowest part of the pelvic and abdominal cavities, may develop pelvic effusion when any situation in the pelvic and abdominal cavities that may cause fluid to leak out.
Classification of pelvic effusion
Non-pathological.
1. After ovulation, when normal women of childbearing age ovulate, oocytes and follicular fluid are discharged together and a small amount of pelvic fluid is produced. When ovulation promotion therapy is performed, multiple follicles can be discharged at the same time due to the effect of drugs, and the pelvic fluid produced by them increases accordingly.
2. History of related surgery: Hysteroscopy and tubal lavage were performed within a short period of time, as fluid was injected into the uterine cavity to investigate the patency of the fallopian tubes, the fluid would enter the pelvic cavity along with the fallopian tubes and accumulate in the pelvic cavity to form pelvic fluid.
The above two conditions are normal and do not need to be treated.
Pathological.
Pelvic inflammatory disease: Pelvic inflammatory disease is an infectious disease of the upper female reproductive tract, mostly occurring in women of childbearing age, and mainly includes endometritis, tubal inflammation, tubo-ovarian abscess, and pelvic peritonitis. Tubitis and tubo-ovarian abscesses are the most common. Due to inflammatory exudation, tubal inflammation and tubo-ovarian abscess can be formed and pelvic effusion can occur. In severe cases, the fallopian tubes are significantly thickened and curved, and the fibrinous purulent exudate increases, causing adhesions with surrounding tissues.
Ectopic pregnancy: the fertilized egg is found outside the uterine cavity is called ectopic pregnancy, the most common one is tubal pregnancy. If the tubal pregnancy miscarries or ruptures and bleeds, blood accumulates in the rectal recess of the uterus and forms pelvic effusion. In this case, the patient often presents with lower abdominal pain on one side, menopause, irregular vaginal bleeding, and a positive urine pregnancy test. In addition to pelvic fluid, ultrasound may reveal a typical ectopic pregnancy with an empty uterine cavity, no gestational sac, abnormal echogenicity in the parametrium, and a germ and primitive ventricular pulsation.
Ruptured ovarian cysts: The most common type is ruptured luteal cysts, which are physiological cysts of the ovary and most of them will disappear spontaneously in 1-3 menstrual cycles. However, they sometimes rupture and bleed, often manifesting as abdominal pain on one side after ovulation, strenuous exercise or intercourse, and fluid accumulation in the pelvic cavity after rupture to form pelvic effusion.
Malignant tumors of the ovaries and fallopian tubes: Malignant tumors occurring in the ovaries and fallopian tubes are usually accompanied by more pelvic and abdominal fluid, and an occupying mass can be detected in the adnexal area at the same time by ultrasound.
Diagnostic criteria of pelvic inflammatory disease
In mild cases, pelvic inflammatory disease is asymptomatic or mild. Common symptoms are lower abdominal pain, increased vaginal discharge, and persistent abdominal pain that worsens after activity or sexual intercourse. In severe cases, fever or even hyperthermia, chills, headache, and lack of appetite may occur.
The minimum diagnostic criteria are the presence of lower abdominal pain in sexually active young women or those at high risk for sexually transmitted diseases, and empirical antibiotic treatment if other causes of lower abdominal pain can be excluded and the gynecological examination meets the minimum diagnostic criteria (painful cervical lifting, pressure in the uterus or adnexal area).
There are also additional and specific criteria. One of the specific criteria is mentioned: vaginal ultrasound or magnetic resonance examination showing thickening of the fallopian tubes and tubal effusion with or without pelvic effusion.
It can be seen that pelvic effusion is not a necessary condition for the diagnosis of pelvic inflammatory disease.
In summary, pelvic effusion is not a sign of pelvic inflammatory disease. If you find pelvic effusion on ultrasound, there is no need to panic, but review whether you have recently been late ovulating or have had surgery. If the answer is no or if you have uncomfortable manifestations, it is necessary to go to your gynecologist and find the cause of pelvic effusion by combining medical history and physical examination and treating it symptomatically. Non-pathological pelvic fluid does not need to be treated, just wait and see what happens.