Uterine Fibroids
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View Uterine Fibroids as PDF for free.
More details
- Words: 345
- Pages: 11
UTERINE FIBROIDS BY DR. JAMES ENIMI OMIETIMI Department of Obstetrics & Gynaecology University of Port Harcourt Teaching Hospital PORT HARCOURT
A
UTERINE FIBROIDS
fibroid is a benign tumour of uterine smooth muscle. It is also termed a leiomyoma. It is the commonest gynaecological tumor in women. It is present in 20-25% of women in the reproductive age group. Systematic histology studies of autopsies of the uterus show a prevalence of up to 50%. It accounted for 82 (45.3%) out of 181 all gynaecological tumours in U.P.T.H in the year 2003. (Annual report.) It was the 3rd commonest cause for admission into
AETIOLOGY-unknown ASSOCIATED RISK FACTORS Age Parity- “fibroids are the reward of virtue, babies the fruit of sin” Race Family history Obesity
AETIO-PATHOLOGY
Ovarian Hormones; Estrogen stimulation of EGF receptors Progesterone stimulation of EGF & stimulation of AIP Ovarian suppression; ↓Metalloproteinase inhibitory activity ↑Metalloproteinase matrix Reduced expression of growth Inhibitory Factors; Monocyte chemotatic protein-1 Monoclonal expansion Single or multiple Spherical in shape, lobulated cut surface with a
TYPES/SITES
Submucous Intramural Subserosal Pedunculated submucosal Pedunculated abdominal Parasitic Cervical Intraligamentous
CLINICAL FEATURES SYMPTOMS 2. Asymptomatic 3. Abnormal uterine bleeding 4. Abdomino-pelvic mass 5. Pain 6. Pressure effects; bladder, ureter, GIT, veins, nerves, pancreas, deep dyspareunia 7. Subfertility
EXAMINATIONS PHYSICAL SIGNS GENERAL EXAM
ABDOMINAL EXAM
BIMANUAL EXAM
COMPLICATIONS OF FIBROIDS
Torsion Haemorrhage Ascitis; Pseudo-Meigs’ syndrome Infection Degeneration; Hyaline Cystic Red degeneration Calcification Malignant change
FIROIDS AND PREGNANCY
Abortions Premature labour Malpresentation Malpositions Obstructed labour Abnormal uterine action Post partum Haemorrhage
DIFFERENTIAL DIAGNOSIS
PREGNANCY OVARIAN TUMORS TUBO-OVARIAN ABSCESS/NEOPLASIA LEIOMYOSARCOMA ADENOMYOSIS ENDOMETRIOSIS ENDOMETRIAL CARCINOMA CONGENITAL ABNORMALITIES
INVESTIGATIONS
FBC URINALYSIS & URINE M/C/S INTRACERVICAL SWAB M/C/S S/E/U/Cr U.S.S. ABD. X-RAY INTRAVENOUS UROGRAPHY HYSTEROSALPINGOGRAPHY SALINE SONOHYSTEROGRAPHY EUA & ENDOMETRIAL BIOPSY MAGNETIC RESONANCE IMAGING HYSTEROSCOPY LAPAROSCOPY
A
UTERINE FIBROIDS
fibroid is a benign tumour of uterine smooth muscle. It is also termed a leiomyoma. It is the commonest gynaecological tumor in women. It is present in 20-25% of women in the reproductive age group. Systematic histology studies of autopsies of the uterus show a prevalence of up to 50%. It accounted for 82 (45.3%) out of 181 all gynaecological tumours in U.P.T.H in the year 2003. (Annual report.) It was the 3rd commonest cause for admission into
AETIOLOGY-unknown ASSOCIATED RISK FACTORS Age Parity- “fibroids are the reward of virtue, babies the fruit of sin” Race Family history Obesity
AETIO-PATHOLOGY
Ovarian Hormones; Estrogen stimulation of EGF receptors Progesterone stimulation of EGF & stimulation of AIP Ovarian suppression; ↓Metalloproteinase inhibitory activity ↑Metalloproteinase matrix Reduced expression of growth Inhibitory Factors; Monocyte chemotatic protein-1 Monoclonal expansion Single or multiple Spherical in shape, lobulated cut surface with a
TYPES/SITES
Submucous Intramural Subserosal Pedunculated submucosal Pedunculated abdominal Parasitic Cervical Intraligamentous
CLINICAL FEATURES SYMPTOMS 2. Asymptomatic 3. Abnormal uterine bleeding 4. Abdomino-pelvic mass 5. Pain 6. Pressure effects; bladder, ureter, GIT, veins, nerves, pancreas, deep dyspareunia 7. Subfertility
EXAMINATIONS PHYSICAL SIGNS GENERAL EXAM
ABDOMINAL EXAM
BIMANUAL EXAM
COMPLICATIONS OF FIBROIDS
Torsion Haemorrhage Ascitis; Pseudo-Meigs’ syndrome Infection Degeneration; Hyaline Cystic Red degeneration Calcification Malignant change
FIROIDS AND PREGNANCY
Abortions Premature labour Malpresentation Malpositions Obstructed labour Abnormal uterine action Post partum Haemorrhage
DIFFERENTIAL DIAGNOSIS
PREGNANCY OVARIAN TUMORS TUBO-OVARIAN ABSCESS/NEOPLASIA LEIOMYOSARCOMA ADENOMYOSIS ENDOMETRIOSIS ENDOMETRIAL CARCINOMA CONGENITAL ABNORMALITIES
INVESTIGATIONS
FBC URINALYSIS & URINE M/C/S INTRACERVICAL SWAB M/C/S S/E/U/Cr U.S.S. ABD. X-RAY INTRAVENOUS UROGRAPHY HYSTEROSALPINGOGRAPHY SALINE SONOHYSTEROGRAPHY EUA & ENDOMETRIAL BIOPSY MAGNETIC RESONANCE IMAGING HYSTEROSCOPY LAPAROSCOPY
Related Documents
Uterine Fibroids
November 2019 11
Uterine Tumor
June 2020 7
Uterine Malignancies
December 2019 4
Uterine Tenderness
May 2020 7
Uterine Myoma
June 2020 6