2.8 Adenomysis Flashcards
1
Q
How common is adenomysis and who gets it?
A
10 % of women.
later repro years and multiparous
may occur with fibroids or endometriosis or alone
hormone dependent, Sx resolve with menopause
2
Q
Presentation of adenomyosis?
A
- dysmenorrhea
- menorrhagia (heavy)
- dyspareunia
a third asymptomatic, may also cause fertility problems
exam: enlarged tender uterus (softer than fibroid uterus)
3
Q
Diagnosis of adenomyosis?
A
transvaginal US is 1st line Ix
MRI and transabdo US are alternatives
Gold standard is histological examination of uterus after hysterectomy
4
Q
Management of adenomyosis?
A
Treat as for HMB (and fibroids) - tranexamic (antifibrinolytic) - if pain mefenamic acid (NSAID) - mirena, COCP, cyclical oral progesterons (POP, depo, implant may also help)
Other:
- GnRH
- endometrial ablation
- uterine artery embolisation
- hysterectomy
5
Q
What pregnancy / fertility things is adenomyosis associated with?
A
- infertility
- miscarriage
- preterm birth
- SGA
- PPROM
- malpresentation
- caesarean
- PPH
