Pregnancy after blowing the fallopian tubes. How is the blowing of the fallopian tubes done? Blowing the fallopian tubes

About existence fallopian tubes women, as a rule, find out in two cases - when they cannot become pregnant and when an ectopic pregnancy occurs.

The fallopian tubes are essential in the onset of pregnancy. It is there that the meeting of the sperm with the egg takes place.

The fallopian tube captures with its free end the egg that has emerged from the ovary and pushes it inside the tube. There, the egg is waiting for the sperm and after fertilization, the embryo is pushed by the tube into the uterine cavity, where it must attach to the uterine lining.

Thus, the fallopian tube must not only be passable, but also must be able to move the fertilized egg into the uterine cavity.

The two most frequent reasons fallopian tube lesions are:

  • inflammatory process (most often chlamydia)
  • carried over surgical intervention, mainly on the pelvic organs (including the removal of appendicitis)

Checking the patency of the fallopian tubes is carried out in the following ways:

  • GHA or MSG (hystero- or metro-salpingography)
  • Hydrosonography
  • Laparoscopy
  • Fertiloscopy

The most commonly used GHA... This is actually X-ray fallopian tubes. In order to take this picture, a woman lies on a special table in the X-ray room, a special tube is inserted into the cervical canal, through which it is inserted into the uterus contrast agent... The contrast agent fills the uterine cavity and from there should flow into the tubes, and from them it should pour out into the abdominal cavity.

It's pretty unpleasant procedure, but on the other hand, it allows in most cases the most accurate and without surgery to assess the patency of the fallopian tubes. In this case, not only the permeability of the pipe is assessed (passable or not), but you can see how the pipe has been changed - it can be expanded, strongly twisted, have constrictions, etc. Of course, the better the snapshot of the tubes is, the more information it can provide.

Sometimes a snapshot of the pipes renders and therapeutic effect(there are cases of pregnancy after the GHA). This is due to the fact that during the procedure, a contrast agent is injected into the uterus under slight pressure and if there were thin tubes in the fallopian tubes internal adhesions, then they break and the pipes become passable.

Until recently (in some clinics it is used to this day), there was a technique for restoring the patency of the fallopian tubes, which was called "hydrotubation". The essence of the method was that every day, for an average of 10 days, a woman with an impassable tube, in the same way as described above, was injected into the uterus with a solution containing various medicines... With the help of these medicines and the pressure created by the syringe plunger, the patency of the pipes was restored - in fact, by blowing them. This technique was practically abandoned, since there were alternative methods treatment, and the technique was extremely painful (many women shouted out loud).

Hydrosonography

In fact, the same as the GHA, but in this case the image is obtained using an ultrasound apparatus. In terms of its information content, this method is significantly inferior to the GHA, but it is better tolerated by the patient.

Laparoscopy

Surgical method for assessing the patency of the fallopian tubes. As a rule, isolated only for this purpose is not used. During laparoscopy, a blue solution is injected into the uterus, which is clearly visible in abdominal cavity... This inspection of the pipes is usually carried out after the operation to separate the adhesions that obstructed the passage of the pipes.

Fertiloscopy

Study of the fallopian tubes and pelvic organs through posterior fornix vagina - this technique is similar to laparoscopy, only the instruments are not inserted through the anterior abdominal wall, and through the vlanalische. This method is combined with hysteroscopy. Small operations can be performed using this method.

Thus, the most optimal method checking the patency of the fallopian tubes is the GHA.

Treatment

There are 4 methods for restoring patency of the fallopian tubes.

  • Laparoscopy
  • Fertiloscopy
  • Recanalization of fallopian tubes
  • Hydrotubation

Of all the listed methods of restoring patency of the fallopian tubes, I have not described recanalization.

Recanalization of fallopian tubes

Using this method, it is possible to restore the patency of the fallopian tubes in their initial sections. Under the control of an X-ray machine, a thin conductor is inserted into the uterine cavity, along which a catheter with a balloon moves. The guidewire is gradually inserted into the mouth of the tube, followed by the catheter. The balloon inflates, widening the lumen of the pipe. The guidewire with the catheter is advanced further until the tube becomes passable. This does not always work out, since if the pipe is heavily overtightened with an outer saddle, then it will not be possible to cope with this from the inside.

Important!

  • Whatever method is used to restore the patency of the fallopian tubes, the effect, as a rule, does not last long, and the likelihood of a relapse is very high.
  • Restoring the patency of the tube does not mean that the fallopian tube is functionally active, in other words, if the tube freely passes fluid, this does not mean that it will be able to ensure the transport of a fertilized egg into the uterine cavity.

Of course, there are cases when normal pregnancy developed with very altered tubes or even with only one tube and one preserved ovary located on opposite sides. These are the very exceptions that prove the rule.

How to decide what to do with the pipes?

The question is whether it is worth doing the restoration of the fallopian tubes or choosing a method of artificial insemination.

Age is of great importance. If you are young and, apart from a problem with the fallopian tubes, you are not expected to have other disorders that prevent pregnancy, you can try to restore the patency of the tubes and try to get pregnant for a year. If it doesn’t work, don’t waste your time and immediately turn to the IVF technique. It so happens that after the birth of the first child through IVF, subsequent pregnancy occurs naturally. This is due to the fact that during a burden, the uterus increases in size and an independent separation of adhesions and restoration of the patency of the fallopian tubes can occur.

After 35 years with prolonged infertility and obstruction of the fallopian tubes, it is worth giving preference to IVF in the first place. Over time, egg quality deteriorates and the risk increases genetic disorders at the fetus. Therefore, it is not advisable to waste time trying to restore the patency of pipes - it takes time, and this plays against you. You also have a big chance after the birth of your first child to solve the problem with the fallopian tubes.

It is important to remember that once the patency of the fallopian tubes is restored, the risk of ectopic pregnancy increases.

Of course, it is difficult to independently decide which tactics to choose, but it seems to me that having an understanding of the problem, it will be easier for you to discuss it with your doctor and jointly make the right decision.

Pertubation- This is the determination of the patency of the fallopian tubes by blowing them with air.

Hydrotubation- a method for determining the patency of the fallopian tubes by introducing liquids (solutions medicines).

These methods have great importance when diagnosing the causes of infertility and are used in cases where all other causes of infertility are excluded (infantilism, tumors, dysfunction of the glands internal secretion, sperm inferiority, etc.).

Various devices have been proposed for blowing the fallopian tubes. The simplest and most convenient is the Mandelstam apparatus.

Hydrotubation is carried out using a hydrotubator. A solution of novocaine or a mixture of drugs (novocaine, antibiotics, hydrocortisone) is used. Hydrotubation with the introduction of drugs into the fallopian tubes is called therapeutic and diagnostic.

Contraindications to blowing and flushing pipes the following:

  • pregnancy (or suspected pregnancy),
  • acute and subacute inflammatory processes,
  • tumors of the uterus and appendages,
  • pathological bleeding, etc.

Required equipment and tools:

  • device for pertubation or hydrotubation (the tip and the rubber tube connecting it to the device must be sterile),
  • phonendoscope,
  • sterile instruments (vaginal spoon-shaped mirrors, an elevator, two pairs of bullet forceps, tweezers).

Technique.

After disinfection of the external genital organs and the vagina, the cervix is ​​exposed with mirrors, the anterior and posterior lips of the cervix are grasped with bullet forceps. Using the uterine probe, the direction of the cervical canal is established. A tip of the appropriate caliber is inserted into the cervical canal (without preliminary expansion), and then into the uterine cavity.

A rubber tube, connected to the tip, is attached to the outlet bend of the vessel. The tip is pressed tightly against the cervix. For better tightness and narrowing of the isthmus of the uterus, the bullet forceps can be crossed.
The assistant injects air into the system with a cylinder, the pressure of which is monitored according to the readings of the pressure gauge.
Air or liquid is pumped to a pressure of 100 mm Hg. Art. (if the fallopian tubes are passable). With obstruction of the fallopian tubes, after a short pause, the pressure is increased to 150 mm Hg. Art., then to the permissible maximum - 180 mm Hg. Art.
Simultaneously with the injection of air or liquid, auscultation of the lower abdomen is performed over the inguinal ligaments, in which a characteristic sound is noted when air or liquid passes through the fallopian tubes. When blowing or flushing pipes, a kymographic record of pressure fluctuations in the system is kept.

The patency of the fallopian tubes is established on the basis of the following data:

1. The air pressure in the system decreases, the pressure gauge arrows fall.
2.At auscultation, there is a characteristic sound of air or liquid passing through the tubes.
3. The kymographic curve rises at the beginning of pertubation or hydrotubation, and decreases when air or liquid passes through the tubes into the abdominal cavity.
4. Air or liquid that appears in the abdominal cavity causes irritation of the phrenic nerve, which is manifested by pain in the shoulder girdle (phrenicus symptom).

A procedure such as blowing the fallopian tubes is used during the diagnosis, with the help of which the causes of infertility are determined. But it is carried out when all possible reasons have already been excluded.

Procedure methods

There are two methods of tubal blowing. The pipes can be blown with air, this procedure is also called pertubation. You can also determine the patency using hydrotubation. This is a method during which a solution or liquid, which consists of drugs, is injected into the lumen of the fallopian tubes. When the cause of infertility is diagnosed, both methods can be used.

Special devices are used to blow through the fallopian tubes. For example, the Mandelstam apparatus, such a device is convenient and simple. For hydrotubation, a hydrotubator is used. For such a procedure, they take a solution of novocaine, or doctors can use a mixture of drugs. When drugs are injected into the pipes during hydrotubation, then it is considered that this is a therapeutic diagnostic procedure.

Contraindications

Pertubation is not a procedure that can be done by all women. Contraindications include:

  • thick tubes of the uterus;
  • accelerated reaction of erythrocyte secretion;
  • high leukoticosis;
  • Availability purulent discharge emerging from the genitals;
  • suspected pregnancy (ectopic, uterine);
  • bleeding from the uterus;
  • the menstrual period, as well as the periods before and after menstruation;
  • inflammatory processes that relate to the pelvic organs.

Before you go to blowing the fallopian tubes, you should first conduct a detailed study on gynecology, analyze the discharge. For a procedure such as pertubation, the best period will be 10-16 days after the onset of menstruation. If the procedure is carried out on other days, there is a risk that an incorrect diagnosis will be made.

How is the blowing of the fallopian tubes?

For a procedure such as blowing pipes, you can use a special apparatus or use a conventional device, which includes a double balloon made of rubber, a mercury manometer, and a uterine tip.

You can start the operation only after the woman has urinated and cleansed the intestines using an enema. Immediately before starting the procedure, all instruments that will be used are sterilized. These include: tweezers, bullet forceps, rubber tube, mirrors, uterine tip. Their sterilization must be approached with special responsibility.

The doctor conducts this procedure on a special chair, which is installed in any gynecological office.

Initially, a special tube made of rubber is connected to the uterine tip.

Then the vaginal part of the cervix is ​​prepared, it is disinfected with alcohol.

Now the cervical canal is directed (a uterine probe is used for this purpose). And then the uterine tip is carefully inserted into the uterine cavity (bullet forceps are taken and the outer lip is captured). So, the opening of the cervical canal is closed with a tip, namely its rubber cone. It is very important that the neck is not dilated prior to insertion of the tip. Then the mucous membrane will remain intact. Air should not escape; for this, the opening of the cervical canal is closed around the tip. How it's done?

The doctor crosses the bullet forceps. Only after that air is injected, but gradually. A mercury manometer should show 150 mm, no more. Otherwise, tubal spasm is possible. During the injection of fluid / air, the doctor listens to the parts of the abdomen, which are located in the region of the inguinal ligaments.

How to determine the degree of permeability of pipes?

It is necessary to highlight the signs that characterize the degree.

  1. If a whistling, gurgling is heard through the abdominal wall, and the pressure drops rapidly on the mercury manometer, it is safe to say that the fallopian tubes have good permeability.
  2. If the doctor noticed a sound, but its tone is high, the pressure drops slowly, then this is a sign of partial patency (that is, there is poor patency in a certain place of the tubes).
  3. If there is no sound, and the mercury column remains in the same place, then this may indicate complete obstruction. This indicates a spasm of the opening of the uterus. To get more accurate results, should do reoperation in a few minutes. In this case, the tip does not need to be removed at the end of the first procedure.

Pertubation is simple manipulation. Here you need to take into account contraindications, observe precautions. Otherwise, as well as with personnel errors, blowing the fallopian tubes can provoke certain complications. For example, inflammation, pyosalpinx rupture, air embolism, which can be fatal.

For the safe conception of a child, one of the necessary conditions is the patency of the fallopian tubes, through which the fertilized egg moves to the uterus. They are 10-12mm long and no more than 5mm in diameter.

It happens that such permeability is violated due to infectious complications abortion, inflammation, hormonal imbalance or other reasons.

When the problem arises female infertility, requires a thorough medical examination and laboratory analyzes for accurate diagnosis.

Bimanual analysis (probing) does not give a clear picture of the condition of the tubes, therefore, the patency of this organ is checked by the salpingography method, when the tubes can be viewed on the monitor using a scanner. If it turns out that there is no patency in the examined organ, it can be purged (pertubation).

Not all women know how pertubation is carried out. Therefore, today on www.site we will try to explain it intelligibly so that you know when it is possible to do the blowing of the fallopian tubes, how it is done, and also when this method is strictly prohibited to use.

Blowing is considered both as a diagnostic procedure and as a therapeutic measure, helping to restore the tubes to their patency. The essence of this procedure is that, with the help of special devices, air is supplied into the uterine cavity, and in the case of sufficient patency of the tubes, it must penetrate into the abdominal cavity. If this is not observed, a final diagnosis of obstruction of the tubes is made.

The procedure for blowing the fallopian tubes requires strict adherence to all necessary measures disinfection and extreme caution. It is carried out in the period between menstruation at the first and second degree of purity of the microflora in the vagina.

Necessarily should not be during this period of any exacerbations of diseases. If there are chronic pathologies, purging can be performed during remission.

This procedure is contraindicated if pregnancy is suspected, if women have cervicitis and colpitis, cervical erosions and exacerbations of inflammation of the reproductive system in its upper areas.

It cannot be carried out during the period active treatment inflammation, in the presence of discharge with blood impurities from the vagina or neoplasms in the uterine cavity and its appendages.

How is tubal blowing done?

Before the start gynecological procedure, the patient must empty the bladder, undergo an enema cleansing.

First, the external genital organs, the uterine cervix and the cervical canal are disinfected with an iodine solution and rubbing alcohol.

The next step is to insert a gynecological speculum and pull out the cervix with special forceps. Then a tip is installed in the cervical canal from a rubber tube leading to a pump that will pump air.

The air supply to the uterus begins very carefully. If the pipes have good permeability, air easily enters the abdominal cavity, and in this case the doctor will record a drop in pressure in the air supply system.

In addition, with a stethoscope or phonendoscope above the inguinal ligaments and abdomen, noise and crackling generated by the passing air can be easily heard. If there is no patency in the tubes, air is pumped into the uterine cavity.

When blowing through the fallopian tubes, the pressure should not exceed 150 mm Hg. pillar. Exceeding the norm is fraught with serious consequences: injury to the walls of the pipes or even their complete rupture.

In the process of carrying out this procedure, specialists carefully monitor all characteristic features that can indicate a patency or obstruction of the fallopian tube.

Blowing is quite simple manipulation. However, if it is carried out contrary to contraindications or with insufficient observance of all precautions and erroneous actions of the medical staff, it can lead to very serious complications(for example, air embolism, etc.) up to death.

Among the most popular factors affecting potential conception, doctors identify clogged fallopian canals. Due to the blockage of the path to the egg, fertilization becomes impossible in principle. Blowing the fallopian tubes is a popular solution to this pressing problem. We will try to figure out when obstruction is diagnosed and how pipe cleaning is carried out in traditional and folk medicine.

The fallopian tubes, also called fallopian tubes, are thin long paths connecting the ovaries to the uterus. The main function of the oviducts is the connection between the egg and the sperm, and it is natural that if obstruction is diagnosed, conception is not feasible. Then the gynecologist prescribes blowing the uterine tract.

As you know, after the rupture of the follicle in the middle menstrual cycle, the egg is sent to the uterus. It carries out its way through the connecting paths, towards the spermatozoa. However, if one of the oviducts is blocked or damaged, fertilization of the corresponding egg will not occur. It should be noted that blocking the channel does not pose a danger to a woman's life. Obstruction of the pipes occurs in the following cases:

  • with outside oviducts;
  • operations in the abdominal cavity, including those not related to the reproductive system;
  • complication of abortion;
  • tumors, abnormalities;
  • ectopic pregnancy;
  • endometriosis;
  • blockage of the canal inside the connecting path.

Particular attention should be paid to the appearance of obstruction inside the oviducts. Quite often, inflammatory processes go unnoticed and are often treated out of time. During the multiplication of pathogenic bacteria, the products of their vital activity in the form of pus, mucus are deposited on the walls fallopian tubes that gradually clogs them up.

Frequent pathogens of asymptomatic diseases are bacteria mycoplasmosis, chlamydia, ureaplasmosis and others. Most dangerous disease associated with obstruction is tuberculosis of the oviducts, which is activated with sharp decline immunity of an infected person.

The more often inflammatory diseases occur, the higher the chance of not having an adequate connection between the uterus and the ovary.

Pipe cleaning procedures

Doctors often send patients to blow the oviduct, but this is not the only way to combat canal dysfunction. Modern medicine suggests hydroturbation, laparoscopy, hysterosalpingography, fertiloscopy and recanalization as the main, most accurate procedures for the diagnosis and cleaning of tubes. The main thing in this matter is to pass all the necessary examinations to detect contraindications to the prescribed operations.

Hydrotubation is the introduction of a mucus-removing fluid with a syringe into the oviduct. The special procedure for flushing the fallopian, in the event of their complete blockage, can be accompanied by severe local pain.

The procedure begins a few days after the end of menstruation and ends when the result of a water pressure of 60 mm Hg is recorded on the recorder tape. Art.

Laparoscopy is less traumatic than hydroturbation, since there is no internal pressure on the walls of the uterine canal. Purification takes place under general anesthesia, several deep holes are made in the abdominal cavity and with the help of special miniature surgical accessories, the uterine canals of women are cleaned.

Cleaning takes place using a camera -on screen a cavity enlarged 40 times is displayed.

Or the GHA is one of the salpingography methods - a type of diagnosis of the state of the oviducts, suggesting an X-ray. It is carried out by introducing cervical canal balloon boat using local anesthesia... The study aims at a more detailed study of the subtleties anatomical structure organism and the causes of infertility.

Fertiloscopy involves a procedure similar to laparoscopy, but without incisions in the abdominal cavity, but through the genitals (cervix).

Recanalization involves cleaning by introducing a contrast fluid catheter, which creates pressure and ruptures the adhesions.

Diagnostics is carried out by a gynecologist in accordance with the assigned preparatory list on a specific day. After clarifying the degree of obstruction, a physical cleaning procedure is prescribed.

How is tubal blowing done?

One of the factors affecting conception is the patency of the tubes, and in the case of diagnostics of various disappointing patency of the oviducts, women are interested in the question: "how is the blowing of the uterine canals done?" Treatment of adhesions in the fallopian tubes is possible without surgery, as mentioned above, recanalization contributes to the rupture of adhesions. The condition for recanalization is the absence inflammatory diseases in the reproductive system.

The uterine canals are cleaned conservatively and operatively. Conservative method involves injections, antibiotics, and physical therapy. A similar technique is relevant in non-started cases - the formation of adhesions is just beginning. And here operational method involves any surgical intervention.

Before carrying out the classic procedure for blowing the uterine tract, emptying is performed Bladder, disinfection of the cervix, cervical canal using ethyl alcohol and iodine. Using a special mirror, the uterus is pulled out, after which a rubber tip is inserted into the cervical canal to bring the air flow.

Depending on the blockage of the pipes, air is supplied of different strengths. The oviducts are considered clean when the pressure drops to 60 mm Hg. Art. Together with the pressure recording, a stethoscope or phonendoscope is used to listen to the noise generated by the air currents.

Is it possible to clean pipes with folk remedies

According to many women, cleaning the oviduct canals is possible with the use of folk remedies... Based on numerous experiences, the international association of gynecologists made a negative conclusion about the common methods of self-medication.

Cleaning the oviduct at home using douching is fraught with dysbiosis in the vagina. It is usually followed by inflammatory processes, which indicates the opposite results of the method. A boron uterus for conception (plant) in some cases provokes ectopic pregnancy... You can read more about this in our about borax uterus.

Use drugs and herbs can cause the opposite effect due to possible intolerance to the elements. If you suspect a blockage of the oviduct, even to prevent the disease, you should seek the help of specialists.

Outcome

Diagnosis and cleaning of the connecting tubes between the uterus and the ovary should be carried out by an experienced specialist using the least traumatic manipulations. Before carrying out diagnostics, a specialist must collect the necessary gynecological tests and set the day of the examination. After diagnostics, it is selected suitable method cleaning. The main thing is not to self-medicate!

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