Fibroid Flashcards
Leiomyoma is more common in
Nulliparous and obese women
Fibroids can arise uncommonly
Broad ligament
8 symptoms
AUB
Reproductive failure
Sub fertility
Recurrent pregnancy loss
Pressure and pain
Bladder and bowel dysfunction
Abdominal distension
It response to
Hyperoestrogenic state
What type of tumor is it
Benign oestrogen dependent tumor
3 forms of degeneration of fibroid
Red
Hyaline
Cystic
Risk factors
Black race
Low parity
Obesity
Hyperoestrogenic state
COCP use
Classification of fibroid
Intramural
Subserous
Submucosa
Cervical
Pedunculated
Protective factor
Multiparity
Smoking
GnRH analogue
Red degeneration occurs in
Mid second trimester of pregnancy
Red degeneration is characterized by
Acute pain
Pressure Symptoms seen in bladder
Urinary retention, frequency, urgency and dysuria
Pressure Symptoms seen in ureter
Hydroureter
Hydronephrosis
Polycythemia
Pressure Symptoms seen in IVC
Hemorrhoids
Edema
Varicose veins
Pressure Symptoms seen in rectum
Constipation
Mainstay of diagnosis
Investigations
Ultrasonography (in presence of large fibroid) to exclude hydronephrosis
MRI for the morphology, size and location
FBC
EUCr
Urinalysis
Chest x-ray and electrocardiography
Medical treatment of HMB
LNG-IUS
Tranexamic acid
Mefenamic acid
COCP
Medical treatment
GnRH agonist
Danazol
Mifepristone
GnRH antagonist
Progestogen
Tamoxifen
Antifibrolytic agent eg tranexamic acid
Surgical treatment
Myomectomy
Endometrial ablation
Myolysis
Hysterectomy
Examples of GnRH agonists
Leuprolide
Buserelin
Goserelin
Naferelin
It induced psudeomenopause
GnRH antagonist
Cetrorelix
Ganirelix
Degarelix
Complications of Uterine artery embolization
Fever
Infection
Fibroid expulsion
Ovarian failure
Effect of fibroid on Pregnancy
Malpresentation
Large for date uterus
Placenta previa and abruptio
Difficulty in palpating fetal part
Poor uterine contractility
Obstructed labour for cervical fi
PPH
Effect of pregnancy on fibroid
Changes in size of fibroid
More soft
Degenerative changes
Torsion of pedunculated fib
Infection in puerperium
