Fluid in the retrouterine space: treatment and causes. How dangerous is fluid in the posterior fornix of the uterus?

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 this dangerous for the fetus and the 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 its normal state is 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.

It is necessary to monitor your own health even in cases where there are 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 appeared in the retrouterine space, do not require special treatment, since they do not pose a danger, then a completely different attitude should be taken towards the causes caused by diseases. In itself, the presence of fluid is not a disease, but important symptom 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 renal 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 termination of pregnancy - abortion, the possibility of the presence of fluid in the retrouterine space cannot be ruled out.
Ectopic pregnancy. The fluid in this case is blood, which may be caused by deformation or damage to the fallopian tube. It is on it that the fertilized egg that has not reached the uterus is most often attached.
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 on the surface of the ovaries. This menstrual blood, located in the 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 of the fluid is required. 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

In some cases, during an ultrasound examination, a specialist detects fluid in the retrouterine space. Normally it shouldn't exist. How dangerous and serious is this? Your gynecologist should provide a decision on this issue. There is no need to worry prematurely - in some cases, treatment is not even required. But it is necessary to consult with specialists.

Where does free fluid come from in the pelvic cavity?

It is a generally accepted opinion that normally there should be no free fluid in any form in the retrouterine space. But, nevertheless, during ovulation, when the dominant follicle ruptures, there is a possibility that the liquid contents will enter the peritoneum. In this case, accumulation of substance behind the uterus may occur. The amount of free fluid in this situation is extremely small. Good specialist can easily distinguish such a case. Which, by the way, is considered an indicator of accomplished ovulation. Soon the fluid will disappear (dissolve or be resorbed).

Fluid in the retrouterine space and gynecological diseases

With this disease, endometrial cells grow in any part of the pelvis. These cells are also involved in menstruation, which means they can cause free fluid to accumulate behind the uterus. But other diseases can affect a similar process. For example, diseased organs secrete an exudative substance. If there are diseases of the pelvic organs (including reproductive organs), it is possible that the presence of free fluid will be diagnosed. Often such a symptom manifests itself in the presence of acute endometritis, as well as in the period after an abortion. Other reasons why fluid appears in the retrouterine space are ovarian rupture (anoplexy) or its cysts, purulent salpingitis. Also, a similar symptom can result from microperforation (small tear) of the endometriosis cyst, due to which its contents leak out. Fluid in the abdominal cavity (ascites) can accumulate due to malignant tumors, diffuse peritonitis, liver diseases, renal or heart failure, pelvioperitonitis and other diseases.

Fluid in the retrouterine space and ectopic pregnancy

One of obvious signs An ectopic pregnancy, when the fertilized egg is attached to the fallopian tube, is the presence of free fluid. In this case, the fluid is blood that flows from the damaged organ. The fertilized egg may be found outside the uterus. The fallopian tube may become deformed or ruptured. With other bleeding in the abdominal cavity, the presence of free fluid can also be diagnosed.

How does a normal state differ from a pathology?

First of all, the presence accompanying symptoms, which occur in the presence of a corresponding pathology. But some diseases occur in a latent form. Therefore, if the ultrasound specialist believes that there may be an abnormality, you should consult your doctor and undergo the necessary examinations. remember, that timely treatment extremely important.

During the period of bearing a child, every woman undergoes ultrasound examinations of the fetus several times. Quite often, doctors conducting examinations write in their conclusions incomprehensible diagnoses and descriptions for the expectant mother, for example, an index amniotic fluid during pregnancy or free fluid in the pelvis. Naturally, every conscious woman in position wants to know what these terms, unclear to the uninitiated, mean.

Subuterine fluid during pregnancy

During an ultrasound of a woman during pregnancy, free fluid in the pelvis is diagnosed in very rare cases. But where does it come from? And is this dangerous for the health of the expectant mother and her baby? In women, fluid behind the uterus may appear due to natural causes, for example, after ovulation or during menstruation. And also after surgical termination of pregnancy (abortion). It is clear that during a normal pregnancy this is impossible. Therefore, if an ultrasound reveals retrouterine fluid during pregnancy, this indicates that the expectant mother has a disease.

Possible diseases

We list the diseases that can cause fluid to form in the pelvis:

chronic and acute inflammatory processes in organs located in the pelvis, they lead to fluid gradually accumulating behind the uterus, most often this is diagnosed in the following diseases: ovarian apoplexy, endometriosis, pelvioperitonitis, hemoperitoneum, purulent salpingitis, ascites, peritonitis;
bleeding in the abdominal cavity;
cancer in latent period, for example, neoplasms on the ovaries;
liver diseases.

As you can see, free fluid during pregnancy is a symptom of many serious illnesses. Naturally, all of the above conditions are potentially dangerous both for the health of the baby and for the health of the woman. In this regard, you need to understand that if an ultrasound during pregnancy revealed fluid in the pelvis, then to the expectant mother You should immediately contact your obstetrician-gynecologist. The doctor, having reviewed the results of the study, will prescribe the woman general analysis blood and urine, and, after studying the data obtained, will prescribe appropriate treatment or refer you to another specialist.

Amniotic fluid during pregnancy

Another unclear term in the conclusion about an ultrasound scan during pregnancy is the amniotic fluid index. What does this concept mean? And what index is the norm?

First, let's find out what amniotic fluid is and why it is needed. Amniotic fluid or, as they simply say, amniotic fluid is a liquid medium inside the fetal bladder. It is she who surrounds the child for all 9 months and plays a big role in ensuring the baby’s life, since metabolism occurs directly through it. Amniotic fluid also performs protective function, it prevents injury to the child due to mild mechanical influences from outside.

The amniotic fluid index during pregnancy is an indicator characterizing the amount of amniotic fluid in the membranes. He is not constant value and changes depending on the period of gestation of the baby. As we know, the baby in the mother’s tummy periodically swallows a certain amount of liquid, and then after some time returns it back to the amniotic sac. This process also affects the amount of amniotic fluid. There is a special table that displays standard indicators amniotic fluid depending on the stage of pregnancy. So, let’s find out what amount of amniotic fluid should be normal, starting from the 16th week of gestation:

at 16 weeks average index is 121 mm, and fluctuations in this value are permissible within the range of 73-201 mm;
at week 17 - 127 mm, permissible fluctuations 77-211 mm;
at week 18 - 133 mm, permissible fluctuations 80-220 mm;
at week 19 - 137 mm, permissible fluctuations 83-225 mm;
at week 20 - 141 mm, permissible fluctuations 86-230 mm;
at week 21 - 143 mm, permissible fluctuations 88-233 mm;
at week 22 - 145 mm, permissible fluctuations 89-235 mm;
at week 23 - 146 mm, permissible fluctuations 90-237 mm;
at week 24 - 147 mm, permissible fluctuations 90-238 mm;
at week 25 - 147 mm, permissible fluctuations 89-240 mm;
at week 26 - 147 mm, permissible fluctuations 89-242 mm;
at week 27 - 156 mm, permissible fluctuations 85-245 mm;
at week 28 - 146 mm, permissible fluctuations 86-249 mm;
at week 29 - 145 mm, permissible fluctuations 84-254 mm;
at week 30 - 145 mm, permissible fluctuations 82-258 mm;
at 31 weeks - 144 mm, permissible fluctuations 79-263 mm;
at week 32 - 144 mm, permissible fluctuations 77-269 mm;
at week 33 - 143 mm, permissible fluctuations 74-274 mm;
at week 34 - 142 mm, permissible fluctuations 72-278 mm;
at week 35 - 140 mm, permissible fluctuations 70-279 mm;
at week 36 - 138 mm, permissible fluctuations 68-279 mm;
at week 37 - 135 mm, permissible fluctuations 66-275 mm;
at week 38 - 132 mm, permissible fluctuations 65-269 mm;
at week 39 - 127 mm, permissible fluctuations 64-255 mm;
at week 40 - 123 mm, permissible fluctuations 63-240 mm;
at 41 weeks - 116 mm, permissible fluctuations 63-216 mm;
at 42 weeks - 110 mm, permissible fluctuations 63-192 mm.

Using the above data, each woman will be able to independently find out whether there is enough amniotic fluid during pregnancy at her term.

When a woman accumulates fluid in the retrouterine space, this does not always mean that something extraordinary is happening in her body. This could very well be normal occurrence associated with the cyclical processes occurring in a woman’s body. But, unfortunately, often such a symptom indicates an illness.

If a woman has an ultrasound childbearing age found free fluid in the pelvis and outside the uterus a fertilized egg surrounded by blood clots, the doctor can diagnose “ectopic pregnancy”.

Diseases of other organs located in the abdominal cavity, for example, the liver, can lead to fluid accumulation.

Usually a woman finds out that she has fluid in the retrouterine space during ultrasound examination. If the disease is hidden, this valuable diagnostic method will be the first to indicate an existing health problem and help the doctor make the correct diagnosis for diseases of the female genital organs.

If you are found to have fluid in the retrouterine space, and there is no other ultrasound evidence of other signs of the disease, you can breathe freely. You are most likely healthy.

Free fluid in a woman's abdomen, behind the uterus, is often found on ultrasound. If there is little fluid, its presence is not considered a pathology. Often fluid accumulates after menstruation or during ovulation. But in some cases, fluid behind the uterus on ultrasound data should be a cause for concern.

Causes of fluid accumulation behind the uterus

Fluid may end up in the cavity behind the uterus and be visualized on ultrasound for a variety of reasons. Some of them are natural and do not pose a health hazard. But normally there should be no fluid behind the uterus or in its cervix, so if it appears on an ultrasound, you should definitely consult a specialist.

What does fluid behind the uterus mean on an ultrasound?

The presence of fluid behind the uterus in sufficient quantity to be displayed on an ultrasound may indicate internal bleeding or inflammatory processes. In the first case, blood will accumulate in the abdominal cavity, in the second - exudative fluid. Considered normal a small amount of fluid behind the uterus, if the ultrasound showed a significant volume, this may indicate serious illnesses uterus or other pelvic organs.

Causes of fluid accumulation

Sometimes fluid behind the uterus appears due to an ectopic pregnancy; in this case, an ultrasound does not detect a fertilized egg in the uterine cavity. However, the patient's pregnancy test will show a positive result.

Also, fluid in the cavity behind the uterus is diagnosed on ultrasound due to endometriosis. The disease is characterized by the growth of endometrial tissue outside the uterus. Endometrial cells bleed during menstruation, which causes blood to appear in the abdominal cavity.

In addition, fluid behind the uterus is detected on ultrasound with purulent salpingitis, endometritis, rupture of the ovary or its cyst. A large volume of fluid indicates more serious diseases, such as malignant tumors ovaries and a number of other pathologies (heart or kidney failure, cirrhosis of the liver), as well as abundant internal bleeding for injuries in the abdominal area.

Fluid behind the uterus during ovulation

When breaking dominant follicle its contents enter the retroperitoneal space. In this case, the specialist may detect some fluid around the uterus on the ultrasound image. Soon after ovulation it will resolve without treatment or health consequences..

Fluid behind the uterus with inflammation

Sometimes inflammatory processes cause the appearance exudative fluid in the abdominal cavity and behind the uterus, ultrasound can reliably diagnose it. As a rule, this occurs due to rupture of the pyosalpinx - accumulation of pus in the lumen fallopian tubes. If an ultrasound showed fluid in the uterus, inflammation of the genitourinary organs is possible.

The inflammatory process is accompanied by fever and pain in the lower abdomen. If the diagnosis is confirmed, the specialist may prescribe medication (antibiotics) or recommend surgery.

How is the ultrasound procedure performed?

The procedure takes place or. The patient takes horizontal position on the couch, the specialist applies the gel to the abdomen and begins to move the sensor over it, then a transvaginal examination is possible. The procedure lasts no more than 15 minutes.

Decoding the result

Determining the exact volume of fluid behind the uterus using ultrasound data can be difficult due to the two-dimensional nature of the image. In addition, the fluid spreads between the organs, which also makes it difficult to determine its exact volume. IN modern medicine It is customary to distinguish the height of the formation by correlating the volume of liquid with it. With a height of up to 10 mm, the volume of liquid is considered insignificant, from 10 to 50 mm - moderate. At a height of more than 50 mm, the volume of fluid behind the uterus, diagnosed by ultrasound, is considered significant.