4. TUBAL BLOCKAGE
Fallopian Tubes are also known as oviducts, uterine
tubes, and salpinges (singular salpinx).
Blocked fallopian tubes are unable to let
the ovum and the sperm converge, thus
making fertilization impossible
5. CAUSES FOR TUBAL BLOCKAGE
Infections: PID, Endometriosis, nfections
after childbirth and intraabdominal infections
including appendicitis and peritonitis.
Distal tubal occlusion (affecting the end towards
the ovary) is typically associated
with hydrosalpinxformation and often caused
by Chlamydia trachomatis.
Adhesions : render it dysfunctional by distorting or
separating it from the ovary
As a method of contraception
6. EVALUATION:
HSG
Sonography can demonstrate tubal abnormalities such as
a hydrosalpinx indicative of tubal occlusion
Laparoscopic chromotubation
TREATMENT
Surgery
IVF
8. CASE STUDY ON TUBAL
BLOCKAGE
Name of the patient : Mrs.Vidhya
Age: 32 years
Sex : Female
Present complaint : Inability to conceive 1 ½ years.
Married for 1 ½ years
Non consanguineous marriage
9. Personal History
Appetite : Good
Diet : mixed diet (veg+ non veg)
Bowels: regular
Sleep : sound sleep
Allergies : absent
Bladder : clear
Addictions: nothing
Occupation : house wife
10. MENSTRUAL HISTORY
Menarche : at the age of 15
LMP: 10-06-15
Interval : 28-30 days/ regular cycles
Duration of bleeding : 4-5 days
Associated complaints : low back ache
11. Past Medical History
Appendicectomy for Appendicytis 4 years ago
3 cycles of OI failed
12. Physical Examination
VITAL DATA:
Pulse : 76 b/m
RR : 18
BP : 120/80
Height : 4.6
Weight : 58 kgs
SYSTEMIC EXAMINATION :
CNS : NAD
CVS : NAD
RS : NAD
P./A : Soft , No tenderness, No organomegaly
13. LABORATORY INVESTIGATIONS
Hysterosalpingogram revealed Bilateral isthemic
tubal block
Follicular study : (TAS+ TVS)
Uterus :
Anteverted, normal in size , measures 7.0 x 4.3 x 4.1
cm
Normal myometrial echotexture
Endometrium : 11mm thickness
Both ovaries : normal in size , shape, echotexture
18. UTTARA VASTI – 4 with Ketakimooladi taila
AVAGAHA SWEDA – 4 Dashamoola QC
INTERNAL MEDICINES
Satpala Ghrta : 1tsp BD in empty stomach
Indukanta QC : Made to kashaya : 75 ml BD before food
Draksharishtam + Lohasavam : 30ml BD after food
Dashamoolaharitaki lehya 1tsp bd
19. MEDICINES ON DISCHARGE
Indukanta QC : made to kashaya : 75ml BD, BF
Chiruwalwadi ghrta : 15ml BD, BF
Mandoora vatakam : 0-1-0 with buttermilk
Punernavasavam : 25ml BD, AF
Dhanwantaram Gutika : 2-0-2
20. FIRST FOLLOW UP
LMP : 09-07-15
Heavy bleeding first 3 days
Dysmenorrhoea reduced
MEDICINES :
Chiravilwadi Ghrta : Day 1 – Day 14 : 15ml BD
Chitrakadi Vati : day 10 – day 14 ; 2 BD
Phala Sarpi : day 15 till next cycle ; 15ml BD
Dashamoola QC for Avagaha from day 4 – day 14
21. SECOND FOLLOW UP
LMP : 30-08-15
Heavy bleeding first 3 days
Very mild Dysmenorrhoea
Weight : 58.5 kg
MEDICINES
Satpala ghrta : day 1 – day 14
Chiruvilwadi ghrta : day 1 – day 14
Punarnavasam : day 1 – day 12, 15ml BD
Phala Sarpi : day 15 till next week
22. THIRD FOLLOW UP
LMP : 29-09-15
Normal flow
Slight clots, No Dysmenorrohea
Weight : 58.5 kg
MEDICINES:
Satpala Ghrta : day 1 – day 12
Chiruvilwadi ghrta : day 1 to day 14
Gokshura guggulu : 2-2-2 for 10 days