Fibroids Flashcards
What are fibroids?
Benign fibrous growths in the uterus
What is biggest risk factor for fibroids?
FaAAAt
What is the classification of fibroids?
Submucosal
Intramural
Subserosal
Which fibroids can pedunculate?
Submucosal
Subserosal
Where do all fibroids start?
Intramural
What is a submucosal fibroid?
An intramural fibroid that grows in towards the uterine cavity
What is a subserosal fibroid?
An intramural fibroid that grows out into the peritoneal cavity
Which fibroid causes bleeding?
Submucosal
How does a submucosal fibroid cause bleeding?
Doesn’t actually bleed itself
- Distorts the uterine walls
Typical presentation?
” 38 y/o gravida 2 para 2 presents for annual check up. She has noticed her periods have been slightly heavier but has not noticed any pain. O/e she has a large uterus. A pregnancy test is negative. “
What do symptoms depend on?
Anatomical area and size
How do large fibroids present?
Pressure on other structures
- Incontinence/urgency
- Constipation
Investigation?
Abdominal exam
USS
Pregnancy test
Hysteroscopy and biopsy if high risk
What may be found on abdominal exam?
Mass - non tender
Moveable uterus
What can happen to fibroids in pregnancy?
Can increase in size
What can be a complication of fibroids in pregnancy?
Obstruction of labour
What needs to be done if a fibroid might obstruct labour?
C section
Pharmacological treatment of fibroids?
Mifepristone
What can be given neoadjuvantly to shrink fibroids?
GnRH analogue - leuprorelein
What fertility sparing surgery can be done to treat fibroids?
Myomectomy
What other surgery can be done to shrink fibroids?
Uterine artery embolisation
