Fibroids are the most common benign tumors of the uterus that arise from the body, not the lining. They have a rare malignant potential and occur in around 40% of women. Symptoms can include dysmenorrhea, menorrhagia, pressure on the bladder and ureters, and infertility. In pregnancy, fibroids can cause miscarriage, preterm labor, postpartum hemorrhage, malpresentation, and cesarean section. Diagnosis is through transabdominal ultrasound and treatment depends on size and symptoms, ranging from observation for small asymptomatic fibroids to myomectomy, hysterectomy, or uterine artery embolization for larger symptomatic fibroids.
Fibroids are the most common benign tumors of the uterus that arise from the body, not the lining. They have a rare malignant potential and occur in around 40% of women. Symptoms can include dysmenorrhea, menorrhagia, pressure on the bladder and ureters, and infertility. In pregnancy, fibroids can cause miscarriage, preterm labor, postpartum hemorrhage, malpresentation, and cesarean section. Diagnosis is through transabdominal ultrasound and treatment depends on size and symptoms, ranging from observation for small asymptomatic fibroids to myomectomy, hysterectomy, or uterine artery embolization for larger symptomatic fibroids.
Fibroids are the most common benign tumors of the uterus that arise from the body, not the lining. They have a rare malignant potential and occur in around 40% of women. Symptoms can include dysmenorrhea, menorrhagia, pressure on the bladder and ureters, and infertility. In pregnancy, fibroids can cause miscarriage, preterm labor, postpartum hemorrhage, malpresentation, and cesarean section. Diagnosis is through transabdominal ultrasound and treatment depends on size and symptoms, ranging from observation for small asymptomatic fibroids to myomectomy, hysterectomy, or uterine artery embolization for larger symptomatic fibroids.
Arise from body of uterus and not lining Malignant potential is rare Incidence: 40% Types: intra-mural, sub-mucosal, sub-serosal, pedunculated Symptoms: o Asymptomatic (most common) o Dysmenorrhea o Menorrhagia: esp. with sub-mucosal fibroids as they will increase the surface area of endometrium o Pressure on bladder > urinary frequency o Pressure on ureter > hydronephrosis o Infertility: due to damage to endometrium > inhibit implantation o In pregnancy: miscarriage, PTL, PPH, malpresentation, CS o In pregnancy: high levels of estrogen > fibroids increase in size > outgrow their own blood supply > ischemia > red degeneration (hemorrhage in fibroids) > severe pain in pregnancy Rx: myomectomy cannot be done > only IV fluids and pain relive until end of pregnancy > myomectomy Dx: TAUS with full bladder Rx: o Asymptomatic + <5cm: no Rx o Symptomatic + >5cm: Pre-op GnRH analogue to shrink fibroids Myomectomy: if fertility desired Hysterectomy: if fertility not desired Uterine artery embolization