scholarly journals Physiopathology and Management of Uterine Fibroids

2020 ◽  
Author(s):  
Joel Noutakdie Tochie ◽  
Therese Gaelle Badjand ◽  
Gregory Ayissi ◽  
Julius Sama Dohbit
Keyword(s):  
Urinary Incontinence ◽  
Pregnant Woman ◽  
Menstrual Cycle ◽  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Spontaneous Abortions ◽  
Red Degeneration ◽  
In Pregnancy

Uterine fibroid is the most encountered benign tumour in women of reproductive age. It causes spontaneous abortions, missed abortions, painful red degeneration or infarction of the fibroids, abnormal foetal presentation, obstructed labour, and an increased likelihood of premature deliveries, caesarean deliveries, postpartum haemorrhage in pregnancy, whereas, in the non-pregnant women it is associated an irregular menstrual cycle sometimes associated with heavy menstrual bleeding, infertility, constipation, urinary incontinence, and leiosarcoma transformation. Till date is pathophysiology and management both in the non-pregnant and pregnant woman have not been well described. In this chapter, we present contemporary evidence to help elucidate this enigma.

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.

scholarly journals Concept of Granthi with reference to uterine fibroid: An Ayurveda review

2021 ◽  
Vol 9 (02) ◽  
Author(s):  
Jaya Umate ◽  
Soudamini Chaudhari
Keyword(s):  
Life Span ◽  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Modern Science ◽  
Reproductive Age ◽  
Significant Morbidity ◽  
Reproductive Life ◽  
Reproductive Life Span ◽  
Gynecological Disease ◽  
Reproductive Age Group

Uterine fibroids are the commonest benign tumor of the uterus and also the commonest benign solid tumor in the female. It can cause significant morbidity in women of a reproductive life span. The exact cause of uterine fibroid is unknown. Prevalence of uterine fibroid 5 -20 % of women in the reproductive age group. It can cause significant morbidity in women of a reproductive life span. Not all fibroids cause symptoms. 50% of women are asymptomatic. Fibroids mainly cause symptoms like menorrhagia, dysmenorrhea and cause pressure symptoms on adjacent viscera i. e. bladder, uterus, rectum which affects the everyday activities of women. In Ayurveda all gynecological disease explained under the term yonivyapad. It can be explained as the anatomical and functional abnormalities of the female reproductive system. In Ayurveda granthi can be correlated with the uterine fibroid. In modern science uterine fibroid treats medically, surgically. But it is challenging to establish a satisfactory conservatory medical treatment to date. so in Ayurveda the main purpose is the management of granthi by samprapti vighatan by use of medicine.

Seeing red degeneration in uterine fibroids in pregnancy: proceed with caution

The Lancet ◽  
2019 ◽  
Vol 394 (10212) ◽  
pp. e37 ◽  
Author(s):  
Ana Sofia Cerdeira ◽  
Mariana Tome ◽  
Niall Moore ◽  
Lee Lim
Keyword(s):  
Uterine Fibroids ◽  
Red Degeneration ◽  
In Pregnancy

scholarly journals Aberrant expression and regulation of NR2F2 and CTNNB1 in uterine fibroids

Reproduction ◽  
2013 ◽  
Vol 146 (2) ◽  
pp. 91-102 ◽  
Author(s):  
Marina Zaitseva ◽  
Sarah J Holdsworth-Carson ◽  
Luke Waldrip ◽  
Julia Nevzorova ◽  
Luciano Martelotto ◽  
...  
Keyword(s):  
Uterine Fibroid ◽  
Molecular Mechanisms ◽  
Primary Cultures ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Causal Role ◽  
Aberrant Expression ◽  
Regulatory Pathways ◽  
Shh Pathway ◽  
Common Benign Tumour

Uterine fibroids are the most common benign tumour afflicting women of reproductive age. Despite the large healthcare burden caused by fibroids, there is only limited understanding of the molecular mechanisms that drive fibroid pathophysiology. Although a large number of genes are differentially expressed in fibroids compared with myometrium, it is likely that most of these differences are a consequence of the fibroid presence and are not causal. The aim of this study was to investigate the expression and regulation of NR2F2 and CTNNB1 based on their potential causal role in uterine fibroid pathophysiology. We used real-time quantitative RT-PCR, western blotting and immunohistochemistry to describe the expression of NR2F2 and CTNNB1 in matched human uterine fibroid and myometrial tissues. Primary myometrial and fibroid smooth muscle cell cultures were treated with progesterone and/or retinoic acid (RA) and sonic hedgehog (SHH) conditioned media to investigate regulatory pathways for these proteins. We showed that NR2F2 and CTNNB1 are aberrantly expressed in fibroid tissue compared with matched myometrium, with strong blood vessel-specific localisation. Although the SHH pathway was shown to be active in myometrial and fibroid primary cultures, it did not regulateNR2F2orCTNNB1mRNA expression. However, progesterone and RA combined regulatedNR2F2mRNA, but notCTNNB1, in myometrial but not fibroid primary cultures. In conclusion, we demonstrate aberrant expression and regulation of NR2F2 and CTNNB1 in uterine fibroids compared with normal myometrium, consistent with the hypothesis that these factors may play a causal role uterine fibroid development.

scholarly journals Ultrasound assessment of the uterine wall after hysteroscopic myomectomy of submucous uterine fibroids

2020 ◽  
Vol 19 (4) ◽  
pp. 5-21
Author(s):  
I.А. Esipova ◽  
◽  
L.M. Kappusheva ◽  
V.G. Breusenko ◽  
D.M. Lyafisheva ◽  
...  
Keyword(s):  
Uterine Fibroid ◽  
Surgical Navigation ◽  
Uterine Fibroids ◽  
Intraoperative Ultrasound ◽  
Precise Determination ◽  
The State ◽  
Reproductive Age ◽  
New Technique ◽  
Hysteroscopic Myomectomy ◽  
A New Technique

Objective. To study the state of the myometrium and the endometrium after hysteroscopic myomectomy of uterine fibroid using 2D/3D transvaginal echography in patients of reproductive age. Patients and methods. We examined 90 patients of reproductive age with submucous uterine fibroid, who underwent 117 one-, two- or three-step hysteroscopic resections performed with a new technique of transcervical myomectomy. 3D transvaginal echography was performed in all patients with target assessment of the fibroid type and the intended resection site, and also with subsequent assessment of its changes. Results. A new technique of fibroid resection with rigid loops was elaborated. New options for noninvasive 3D-US in preoperative diagnosis of uterine fibroids have been determined. Owing to 3D-US, the state of the endometrium, myometrium at the «resection site» were studied for the first time. Indications for one-, two- and tree-step resections have been specified. Conclusion. 3D transvaginal echography at the stage of planning hysteroscopic myomectomy allows not only a more precise determination of the fibroid type, assessment of its location and size, but also prediction of the length of operative intervention, the likelihood of multi-step resection and a risk of developing postoperative complications, as well as recommendation of other surgical treatments. Intraoperative ultrasound surgical navigation was introduced, which in combination with an appropriate resection technique permits to enhance the safety of surgical procedure. Depending on the echographic image of the endometrium and myometrium at the «resection site», specific recommendations have been formulated on management of the postoperative period that can permit to prevent the formation of synechiae and to determine precise terms of possible pregnancy occurrence. Key words: infertility, hysteroscopic myomectomy, resection site, uterine fibroid, reproductive age, submucosal fibroid, ultrasound examination, 3D-US

scholarly journals Current trends in the pharmacotherapy of uterine myoma, associated with heavy menstrual bleeding and anemia: review

2020 ◽  
Author(s):  
Z. V. Revazova ◽  
L. V. Adamyan ◽  
O. N. Loginova ◽  
L. M. Manukyan ◽  
K. N. Arslanyan
Keyword(s):  
Uterine Fibroids ◽  
Reproductive Function ◽  
Uterine Myoma ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Cochrane Library ◽  
Pharmacological Agents ◽  
Surgical Interventions ◽  
Current Trends

Aim: to summarize results of up-to-date world researches on the current trends of symptomatic myoma treatment.Materials and Мethods. A search of publications was carried out in the main international databases in Russian and English languages: PubMed/MEDLINE, The Cochrane Library, Embase, eLibrary. The analysis included studies published over the past 10 years examining the clinical efficacy and safety of various groups of pharmacological agents for the treatment of uterine myoma combined with heavy menstrual bleeding in women of reproductive age.Results. Currently, the treatment of uterine fibroids is divided into three main methods: surgical, minimally invasive organ-preserving methods, and pharmacotherapy. Until now, surgical intervention remains the main method of treatment, and, unfortunately, is often carried out in the volume of hysterectomy. However, today it is important to have a personalized approach to the management of a patient with symptomatic uterine myoma, taking into account her desire to preserve reproductive function. The development of the possibilities of drug therapy made a great contribution to the optimization of managing such patients.Conclusion. The global trend is to decrease the number of radical interventions, as well as the development and improvement of new methods of treating symptomatic uterine fibroids. Currently, pharmacotherapy of leiomyoma can significantly improve the quality of life of patients, reduce radical surgical interventions, optimize surgical treatment, and in certain situations, completely eliminate the need for surgery.

scholarly journals Improvement in Quality of Life After Myomectomy

2020 ◽  
Author(s):  
Ehab Helmy Abdel Malek Fahmy ◽  
Constance Liew Sat Lin ◽  
Alvin Oliver Payus ◽  
Rhanye Mac Guad ◽  
May Zaw Soe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Menstrual Cycle ◽  
Pelvic Pain ◽  
Uterine Fibroids ◽  
Heavy Menstrual Bleeding ◽  
Anxiety And Depression ◽  
Poor Sleep ◽  
Childbearing Age ◽  
Menstrual Disorder

Dysmenorrhea is one of the leading causes of pelvic pain and menstrual disorder among women during childbearing age. The burden of dysmenorrhea is greater than any other gynaecological complaint. Some women have severe dysmenorrhea which renders them incapacitated for days each menstrual cycle requiring absence from study or duty, frequently requiring pain killer, restriction of daily performance, poor sleep, negative moods such as anxiety and depression. A 31-year-old female presented with severe dysmenorrhea and heavy menstrual bleeding (HMB) as a cause of multiple uterine fibroids, underwent surgeries to remove 100 fibroids from her uterus which has improved her quality of life, eliminating her dysmenorrhea and menstrual abnormalities.

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.

Sign in / Sign up

Export Citation Format

Share Document