A rehabilitation of women is after ectopic pregnancy

Abstract

DOI: 10.52705/2788-6190-2025-4-17
УДК 618.31-06-036.82

The objective: to develop and inculcate the complex of rehabilitation measures for women after ectopic pregnancy taking into account the features of psychosomatic status.
Materials and methods. For the decision of the put purpose was conducted clinical-andstatistical analysis of indexes complex clinical-and-laboratory inspection, surgical treatment and rehabilitation period in 165 patients, who were undergoing operative treatment concerning ectopic pregnancy. The division of contingent of patients with was conducted 2 groups: 1 group – operated laparoscopically (96 women) and 2 groups – operated laparotomically (69 women). The complex estimation of the state of women with ectopic pregnancy was conducted in gynaecological permanent establishment to and after to the operation, and also in a rehabilitation period. The criterion of authenticity of diagnosis was a complete surgical diagnosis and him morphological confirmation. A supervision and inspection of patients was carried out during 3 after surgical interference concerning ectopic pregnancy with the analysis of remote results of treatment. By the criterion of efficiency of measures which are conducted, in a rehabilitation period there was the state of sexual sphere of women and them reproductive function. Age of the inspected patients hesitated from 16 to 44 years, on the average – 29,8 ± 2,2 year. For patients the extrasomatic was studied and obstetric gynaecological anamnesis, a complete clinical inspection was conducted by the generally accepted methods, that included estimation of general somatic and gynaecological status. For the estimation of psychological status of patients methods were used: 1) clinical conversation; 2) tests STAI on determination of the personal and reactive anxiety; 3) method of diagnostics of self appraisal of mental conditions; 4) adapted variant of test of MMPI; 5) consultation of clinical psychologist.
Results. An uterogestation comes for patients, which are operated concerning ectopic pregnancy laparoscopically in 1,7 times more frequent than for patients which are operated concerning ectopic pregnancy of laparotomically. Infertility comes for patients, which are operated concerning ectopic pregnancy laparoscopically in 2,2 times rarer than for patients which are operated concerning ectopic pregnancy of laparotomically. The got results specify on circumstance that operative interference by laparotomy is frequently accompanied by strengthening of violations of menstrual cycle for gynaecological patients, while after interferences laparoscopically a correction appears toward normalization of menstrual cycle in parts of patients. Adding up of findings, allowed to develop and inculcate in practice the algorithms of diagnostics, choice of method of operative interference and program of postoperative rehabilitation.
Conclusions. In the period of rehabilitation after the carried operative treatment of tubal pregnancy favourable psychological adaptation takes place in 65,0% women, in 35,0% is pathological psychological adaptation. Normalization of menstrual and fertile functions more effective takes place for women which carried an operation laparoscopic access. The use of psychological support of women in the period of rehabilitation is instrumental in greater optimization of menstrual (70,0% and 53,8%) and fertile (60,0% and 30,8%) function of patients of both groups (by laparoscopic access and laparotomic access respectively).