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Mittelschmerz. Sonographic demonstration.

L E Hann, D A Hall, E B Black

    JAMA
    |June 22, 1979
    PubMed
    Summary
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    Pelvic ultrasonography revealed free fluid in 40% of normal menstrual cycles during ovulation. Painful ovulation (Mittelschmerz) was associated with fluid detection, confirming ovulation as a physiological trauma.

    Area of Science:

    • Reproductive endocrinology
    • Medical imaging
    • Gynecology

    Background:

    • Follicular development and rupture are key events in the menstrual cycle.
    • Ovulation is sometimes associated with pelvic pain, known as Mittelschmerz.
    • The presence and significance of free fluid in the pelvis during the menstrual cycle require further elucidation.

    Purpose of the Study:

    • To investigate the presence and characteristics of free pelvic fluid during the mid-menstrual cycle using ultrasonography.
    • To correlate sonographic findings of free fluid with ovulatory events and associated pain.

    Main Methods:

    • Pelvic ultrasonography was performed in normal women during the mid-menstrual cycle.
    • Fluid in the cul-de-sac was quantified and described.

    Related Experiment Videos

  • Correlation between fluid presence, ovulation timing, and reported pelvic pain (Mittelschmerz) was analyzed.

    • Main Results:

    • Small quantities of free fluid were detected in 40% of observed menstrual cycles.
    • In cycles with reported pain during ovulation, free fluid was ultrasonically demonstrated in two-thirds of cases.
    • Sonographic evidence of fluid at ovulation supports its occurrence during Mittelschmerz.

    Conclusions:

    • The presence of free pelvic fluid is a common finding during the mid-menstrual cycle.
    • Sonographic detection of fluid at ovulation correlates with Mittelschmerz, supporting ovulation as a physiological event involving minor trauma.