scholarly journals Large Uterine Fibroids in Pregnancy with Successful Caesarean Myomectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Edu Eyong ◽  
Okon A. Okon
Keyword(s):  
Birth Weight ◽  
Uterine Fibroid ◽  
Reproductive Tract ◽  
Uterine Fibroids ◽  
Female Reproductive Tract ◽  
Benign Tumour ◽  
First Line ◽  
Female Baby ◽  
In Pregnancy

Uterine fibroid is the commonest benign tumour of the female reproductive tract. It occurs in 20–40% of women, whereas the estimated incidence in pregnancy is 0.1–3.9%. Uterine fibroid in pregnancy is usually asymptomatic with complications occurring in 10–30% of cases. The first line of management is conservative with counselling for myomectomy after delivery. However, in the presence of intractable symptoms, both antepartum myomectomy and caesarean myomectomy have been reported to be successfully performed in carefully selected cases. We report a case of large subserous uterine fibroid in pregnancy that was referred to our centre at 14 weeks of gestation. She developed generalized body weakness, backache, and breathlessness at 27 weeks gestation. Thus, she was admitted and managed conservatively for eight weeks with significant relief of symptoms. She eventually had a caesarean myomectomy at 35 weeks of gestation; the outcome was a live female baby with a birth weight of 2.3 kg and a large subserous fibroid weighing 9.5 kg. We can therefore say that caesarean myomectomy can be safely performed in carefully selected cases.

Mechanical Signaling and Extracellular Matrix in Uterine Fibroids

2017 ◽  
Vol 35 (06) ◽  
pp. 487-493 ◽  
Author(s):  
Saima Rafique ◽  
James Segars ◽  
Phyllis Leppert
Keyword(s):  
Gene Expression ◽  
Extracellular Matrix ◽  
Reproductive Tract ◽  
Critical Role ◽  
Uterine Fibroids ◽  
Female Reproductive Tract ◽  
Benign Tumors ◽  
Mechanical Signaling ◽  
Abnormal Cells ◽  
Fibroid Growth

AbstractFibroids (uterine leiomyomas) are the most common benign tumors of the female reproductive tract. Steroid hormones, growth factors, and cytokines have long been implicated in fibroid growth; however, research suggests that changes in the extracellular matrix and mechanical signaling play a critical role in fibroid growth and differentiation. Studies have shown that growth of fibroids is related to the change in the volume and composition of extracellular matrix with increased deposition of abnormal collagen, glycoproteins, laminins, fibronectins, and an increased osmotic stress. These changes generate mechanical stress which is converted to chemical signals in the cells through mechanotransduction and eventually affects gene expression and protein synthesis. Current studies also suggest that mechanical signaling in fibroid cells is abnormal as evidenced by decreased apoptosis of abnormal cells and deposition of a stiff extracellular matrix promoting fibrosis. Understanding and defining these mechanisms could help design new therapies for the treatment of fibroids.

scholarly journals 5-Hydroxymethylcytosine Promotes Proliferation of Human Uterine Leiomyoma: A Biological Link to a New Epigenetic Modification in Benign Tumors

2014 ◽  
Vol 99 (11) ◽  
pp. E2437-E2445 ◽  
Author(s):  
Antonia Navarro ◽  
Ping Yin ◽  
Masanori Ono ◽  
Diana Monsivais ◽  
Molly B. Moravek ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Uterine Leiomyoma ◽  
Reproductive Tract ◽  
Enzyme Inhibitor ◽  
Malignant Tumors ◽  
Epigenetic Modification ◽  
Uterine Fibroids ◽  
Female Reproductive Tract ◽  
Immunofluorescent Staining ◽  
Benign Tumors

Context: Uterine leiomyoma, or fibroids, represent the most common benign tumors of the female reproductive tract. A newly discovered epigenetic modification, 5-hydroxymethylation (5-hmC), and its regulators, the TET (Ten Eleven Translocation) enzymes, were implicated in the pathology of malignant tumors; however, their roles in benign tumors, including uterine fibroids, remain unknown. Objective: To determine the role of 5-hmC and TET proteins in the pathogenesis of leiomyoma using human uterine leiomyoma and normal matched myometrial tissues and primary cells. Design: 5-hmC levels were determined by ELISA and immunofluorescent staining in matched myometrial and leiomyoma tissues. TET expression was analyzed by quantitative RT-PCR and immunoblotting. TET1 or TET3 were silenced or inhibited by small interfering RNA or 2-hydroxyglutarate to study their effects on 5-hmC content and cell proliferation. Results: We demonstrated significantly higher 5-hmC levels in the genomic DNA of leiomyoma tissue compared to normal myometrial tissue. The increase in 5-hmC levels was associated with the up-regulation of TET1 or TET3 mRNA and protein expression in leiomyoma tissue. TET1 or TET3 knockdown significantly reduced 5-hmC levels in leiomyoma cells and decreased cell proliferation. Treatment with 2-hydroxyglutarate, a competitive TET enzyme inhibitor, significantly decreased both 5-hmC content and cell proliferation of leiomyoma cells. Conclusion: An epigenetic imbalance in the 5-hmC content of leiomyoma tissue, caused by up-regulation of the TET1 and TET3 enzymes, might lead to discovery of new therapeutic targets in leiomyoma.

scholarly journals Comparative study between vaginal natural progesterone and oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy

2020 ◽  
Vol 9 (8) ◽  
pp. 3330
Author(s):  
Nermeen M. Hefila ◽  
Tarek A. Karkour ◽  
Sara M. Elghareeb ◽  
Tamer M. Abdeldaiem
Keyword(s):  
Uterine Fibroid ◽  
Gestational Age ◽  
Uterine Fibroids ◽  
Pregnant Females ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Red Degeneration ◽  
In Pregnancy ◽  
Natural Progesterone

Background: Uterine leiomyomas are highly prevalent benign monoclonal tumors, arising from the smooth muscle of the myometrium; they occur in up to 50-60% of reproductive age women, causing significant morbidity in up to 30% of women. The most serious complication of uterine fibroids; is red degeneration that causes severe pain, and may lead to preterm labour, miscarriage, fetal and maternal morbidity and mortality. Objective of this study was designed to compare between the effect of vaginal natural MP and oral dydrogesterone in prevention of red degeneration of uterine fibroid during pregnancy.Methods: Patients were recruited from El-Shatby Maternity University Hospital. They were 50 pregnant females, diagnosed having a uterine fibroid more than 3 cm in size then there were divided into two groups, Group A: twenty-five treated by vaginal natural progesterone, Group B: twenty-five treated by oral dydrogesterone. All patients at 14-15 weeks of gestational age underwent complete history taking, clinical examination and ultrasound examination for mean gestational age and assessment of the type and uterine fibroid.Results: Results showed that there were no statistically significant differences as regards age, obstetric history (gravidity and parity), number, Site, grade and size of the fibroid. There was a significant difference between the two studied groups, regarding the acute abdominal pain, it occurred to only 3 cases (12%) in Group A, versus to 16 cases (64%) in Group B. Regarding occurrence of red degeneration, it occurred only to 3 cases (12%) in Group A, while in Group B it occurred to 15 cases (60%).Conclusions: Vaginal natural micronized progesterone is more effective than oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy with fewer complications. Vaginal natural progesterone daily dose of 200 mg is recommended to all pregnant females with uterine fibroids.

Colony stimulating factor-1 (CSF-1) in pregnancy

1992 ◽  
Vol 1 (1) ◽  
pp. 83-97 ◽  
Author(s):  
Eric Daiter ◽  
Jeffrey W Pollard
Keyword(s):  
Growth Factors ◽  
Sex Steroids ◽  
Reproductive Tract ◽  
Female Reproductive Tract ◽  
Colony Stimulating Factor ◽  
Decidual Cells ◽  
Uterine Growth ◽  
Gynaecological Tumours ◽  
Stimulating Factor ◽  
In Pregnancy

Uterine growth factors appear to play a role in the regulation of pregnancy. One of these, colony stimulating factor-1 (CSF-1), synthesized by the uterine epithelium under the control of female sex steroids, has been shown to have important functions both before implantation and during the formation of the placenta. In the female reproductive tract the CSF-1 receptor, the product of the c-fms proto-oncogene, is expressed in decidual cells, trophoblasts and macrophages, indicating that these cells are the primary targets for CSF-1. This article reviews the biology of CSF-1 during gestation as well as the possible involvement of CSF-1 and its receptor in the aetiology of gynaecological tumours.

scholarly journals Recent scientific advances in leiomyoma (uterine fibroids) research facilitates better understanding and management

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 183 ◽  
Author(s):  
Darlene K. Taylor ◽  
Kristine Holthouser ◽  
James H. Segars ◽  
Phyllis C. Leppert
Keyword(s):  
Reproductive Tract ◽  
Treatment Options ◽  
Uterine Fibroids ◽  
Medical Problem ◽  
Female Reproductive Tract ◽  
Surgical Approaches ◽  
Clinical Method ◽  
Diagnostic Approaches ◽  
Molecular Components ◽  
Non Surgical Treatment

Uterine leiomyomas (fibroids) are the most prevalent medical problem of the female reproductive tract, but there are few non-surgical treatment options. Although many advances in the understanding of the molecular components of these tumors have occurred over the past five years, an effective pharmaceutical approach remains elusive. Further, there is currently no clinical method to distinguish a benign uterine leiomyoma from a malignant leiomyosarcoma prior to treatment, a pressing need given concerns about the use of the power morcellator for minimally invasive surgery. This paper reviews current studies regarding the molecular biology of uterine fibroids, discusses non-surgical approaches and suggests new cutting-edge therapeutic and diagnostic approaches.

scholarly journals A study to correlate association between vitamin D with fibroid and its supplementation in the progression of the disease

2020 ◽  
Vol 9 (4) ◽  
pp. 1477
Author(s):  
Somila Xess ◽  
Jaiprakash Sahu
Keyword(s):  
Vitamin D ◽  
Reproductive Tract ◽  
Uterine Fibroids ◽  
Hypovitaminosis D ◽  
Vitamin D Supplementation ◽  
Female Reproductive Tract ◽  
Benign Tumors ◽  
Control Group ◽  
Study Group ◽  
Increased Risk

Background: Uterine fibroids, or leiomyomas are the most common benign tumors of the female reproductive tract, affecting up to 60% of Indian women with only 25% of women who are symptomatic. Symptoms do not always correlate with the size, number, or location of the fibroids. Recent studies suggest that hypovitaminosis D is associated with an increased risk of uterine fibroids.Methods: Total 110 women diagnosed with fibroid in USG were included in the study. Inclusion and exclusion criteria were applied and size of the fibroid noted. 60 women were included in the study group who took Vitamin D supplementation and 50 women in the control group who didn’t perform the study properly.Results: The growth pattern of fibroids with study group under supplementation with 25-OH-D3 seems to be stable, with no increases or decreases in size or number of identified lesions. Instead, women in control group, who did not perform appropriate vitamin D supplementation seem to have a slight but significant increase in size of the lesions.Conclusions: It was seen that hypovitaminosis D was associated with fibroid and thus supplementation with Vitamin D helped in the shrinkage of fibroid or slower the progression of the disease.

scholarly journals Leiomyosarcoma in pregnancy: Incidental finding during routine caesarean section

2021 ◽  
Vol 4 (3) ◽  
pp. 092-095
Author(s):  
Tang Toon Wen ◽  
Jessie Phoon Wai Leng
Keyword(s):  
Caesarean Section ◽  
Reproductive Tract ◽  
Incidental Finding ◽  
Elective Caesarean Section ◽  
Breech Presentation ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Female Reproductive Tract ◽  
Uterine Leiomyosarcoma ◽  
In Pregnancy

Uterine leiomyosarcoma (LMS) is uncommon tumour arising from the female reproductive tract. Incidence of LMS in pregnancy is extremely rare, with only 10 cases reported thus far in medical literature. We present a case of myomectomy performed during elective caesarean section for breech presentation, due to its easy accessibility and well contracted uterus. Subsequent histology revealed LMS on final specimen. Patient subsequently underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy. No chemotherapy was given as she opted for close clinical- radiological monitoring instead. This case report highlights the importance of discussion with patients regarding the risk of occult malignancy in a fibroid uterus. Appropriate management of uterine leiomyosarcoma in pregnancy remains unclear. Consideration of removing an enlarging leiomyoma during caesarean section might be ideal in view of its malignant potential, just like in this case; however, location of the tumour and risk of bleeding needs to be weighed. Ultimately, management of such cases needs proper discussion between obstetrician and the patient.

Determinants of Uterine Fibroids Among Married Women Attending Public Hospitals in Lahore, Pakistan

2020 ◽  
pp. 33-37
Author(s):  
OJS Admin
Keyword(s):  
Smooth Muscle ◽  
Reproductive Tract ◽  
Uterine Fibroids ◽  
Married Women ◽  
Female Reproductive Tract ◽  
Public Hospitals ◽  
Benign Tumors

Uterine broids (leiomyomas) are the most common tumors of female reproductive tract; these are the benign tumors of smooth muscle. Fibroids have been reported to occur in up to 70% of women by the age of 50 years.

scholarly journals Huge Cystadenocarcinoma of the Ovary Disguising as Degenerating Uterine Fibroid in Pregnancy: Case Report and Literature Review

2021 ◽  
Author(s):  
Adedapo Ande ◽  
Maradona Isikhuemen ◽  
Weyinmi Kubeyinje ◽  
Michael Ezeanochie
Keyword(s):  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Abdominal Distension ◽  
Case Presentation ◽  
Serous Cystadenocarcinoma ◽  
Index Pregnancy ◽  
Ovarian Tumours ◽  
Adenocarcinoma Of The Ovary ◽  
High Index Of Suspicion ◽  
In Pregnancy

Abstract Background: Ovarian malignancy is rare in pregnancy and constitutes 3 – 6% of all ovarian tumours associated with pregnancy. It is usually asymptomatic, detected during routine antenatal ultrasound scan. Treatment is mainly surgical. The aim of this report is to share our experience in the management of a referred case of papillary serous cystadenocarcinoma of the ovary disguising as degenerating uterine fibroid in pregnancy. The diagnostic challenges and treatment are highlighted with a view to improving care in our setting.Case presentation: A 29 year old gravida 2 para 1 with one living child was referred to our unit at 25 weeks gestation with complaint of progressive painful abdominal distension with dyspnoea noticed in the index pregnancy. Ultrasound scans were suggestive of uterine fibroid in pregnancy with degenerative changes for which she had conservative management. Due to worsening symptoms, she had laparotomy and a huge ovarian mass was removed alongside the affected ovary. Histology confirmed Serous Papillary Cyst Adenocarcinoma of the ovary. She is doing well on adjuvant chemotherapy. Conclusion: A high index of suspicion for ovarian malignancies in pregnancy, coupled with complementing MRI (when available) with ultrasound to differentiate degenerating uterine fibroids is suggested/recommended.

Uterine Fibroids: Bridging Genomic Defects and Chronic Inflammation

2017 ◽  
Vol 35 (06) ◽  
pp. 494-498 ◽  
Author(s):  
Abdeljabar El Andaloussi ◽  
Zuni Chaudhry ◽  
Ayman Al-Hendy ◽  
Nahed Ismail
Keyword(s):  
Reproductive Tract ◽  
Inflammatory Responses ◽  
Current Knowledge ◽  
Uterine Fibroids ◽  
The United States ◽  
Female Reproductive Tract ◽  
Driver Mutations ◽  
Benign Tumors ◽  
Med12 Gene ◽  
Abnormal Vaginal Bleeding

AbstractUterine fibroids (UF; aka leiomyoma, myomas) are the most common benign tumors of female reproductive tract. They are highly prevalent, with 70 to 80% of women burdened by the end of their reproductive years. Fibroids are a leading cause of pelvic pain, abnormal vaginal bleeding, pelvic bulk symptoms, miscarriage, and infertility. They are the leading indication for hysterectomy, and costs exceed 34 billion dollars annually in the United States alone. Recently, somatic mutations in exons 1 and 2 of Med12 gene emerged as common UF driver mutations. Unfortunately, the detailed etiology of UF is not fully realized. Particularly, very little is known about possible dysregulation of inflammatory and immune processes and their possible contribution to UF pathogenesis. The notion on possible impact of altered estrogen and progesterone signaling in UF on inflammatory responses and DNA repair machinery that can conceivably lead to tumor-specific somatic mutation is indeed an intriguing concept which has some foundation in available observation in other hormonally responsive tissues. This review highlights and summarizes our current knowledge on the convergence of such pathways and their relevance for UF pathogenesis.

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