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uterine fibroid.pptx

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uterine fibroid.pptx

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Fibroid
Commonest benign tumour in females.
Histologically composed of Smooth muscles fibres and fibrous connective tissues.
Aka lieomyoma, myoma and fibromyoma.
Incidence
Higher incidence in dark coloured females.
More common in nulliparous or child bearing age.
Prevalence is higher in 35 – 45 years.
Aetiology
Aetiology is unclear at present.
Hypothesis
Chromosomal abnormality:
Rearrangement or deletion at chromosome 6 or 7.
Somatic mutations in myometrial cells.
Role of polypeptide growth factors :
Epidermal GF, Insulin-like GF Transforming GF stimulate the growth.

Types of Uterine Fibroids
Pathology
Naked eye appearance:
Enlarged uterus, distorted shape.
Firm appearance on touch.
Cut section :
Smooth, whitish, whorled and trabeculation.
False capsule formation.
Periphery is more vascular.
Cut section of Uterine Fibroid
Secondary changes in fibroids:
Degeneration
Atrophy
Necrosis
Infection
Vascular changes
Sarcomatous changes
Clinical features
Asymptomatic
Menstrual abnormalities menorrhagia, metrorhhagia
Dysmenorrhoea
Dyspareunia
Infertility
Recurrent pregnancy loss
Abdominal enlargement
Pelvic pain
Investigations
USG
Pelvis, TVS
MRI
HSG
Hysteroscopy
Uterine curettage
Medical Management
Objectives :
To improve menorrhagia
To correct anaemia
To reduce vascularity and size of tumour
To postpone surgery
Drug Therapy
Antiprogesterones (Mifeprestone)
Danazol
GnRH analogues
LNG-IUS
Prostaglandin synthetase inhibitors.
Surgical Management of Uterine Fibroids
Myomectomy
Embolotherapy
Hysterectomy
Cervical Fibroids
Symptoms :
Anterior Cervical Fibroids
Posterior Cervical Fibroids
Lateral Cervical Fibroids
Central Cervical Fibroids
Treatment
Supravaginal cervix : Myomectomy
Infravaginal cervix :

Fibroid
Commonest benign tumour in females.
Histologically composed of Smooth muscles fibres and fibrous connective tissues.
Aka lieomyoma, myoma and fibromyoma.
Incidence
Higher incidence in dark coloured females.
More common in nulliparous or child bearing age.
Prevalence is higher in 35 – 45 years.
Aetiology
Aetiology is unclear at present.
Hypothesis
Chromosomal abnormality:
Rearrangement or deletion at chromosome 6 or 7.
Somatic mutations in myometrial cells.
Role of polypeptide growth factors :
Epidermal GF, Insulin-like GF Transforming GF stimulate the growth.

Types of Uterine Fibroids
Pathology
Naked eye appearance:
Enlarged uterus, distorted shape.
Firm appearance on touch.
Cut section :
Smooth, whitish, whorled and trabeculation.
False capsule formation.
Periphery is more vascular.
Cut section of Uterine Fibroid
Secondary changes in fibroids:
Degeneration
Atrophy
Necrosis
Infection
Vascular changes
Sarcomatous changes
Clinical features
Asymptomatic
Menstrual abnormalities menorrhagia, metrorhhagia
Dysmenorrhoea
Dyspareunia
Infertility
Recurrent pregnancy loss
Abdominal enlargement
Pelvic pain
Investigations
USG
Pelvis, TVS
MRI
HSG
Hysteroscopy
Uterine curettage
Medical Management
Objectives :
To improve menorrhagia
To correct anaemia
To reduce vascularity and size of tumour
To postpone surgery
Drug Therapy
Antiprogesterones (Mifeprestone)
Danazol
GnRH analogues
LNG-IUS
Prostaglandin synthetase inhibitors.
Surgical Management of Uterine Fibroids
Myomectomy
Embolotherapy
Hysterectomy
Cervical Fibroids
Symptoms :
Anterior Cervical Fibroids
Posterior Cervical Fibroids
Lateral Cervical Fibroids
Central Cervical Fibroids
Treatment
Supravaginal cervix : Myomectomy
Infravaginal cervix :

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uterine fibroid.pptx

  1. 1. UTERINE FIBROID Dr. Yashika
  2. 2. Fibroid  Commonest benign tumour in females.  Histologically composed of Smooth muscles fibres and fibrous connective tissues.  Aka lieomyoma, myoma and fibromyoma.
  3. 3. Incidence  Higher incidence in dark coloured females.  More common in nulliparous or child bearing age.  Prevalence is higher in 35 – 45 years.
  4. 4. Aetiology  Aetiology is unclear at present.  Hypothesis Chromosomal abnormality: Rearrangement or deletion at chromosome 6 or 7. Somatic mutations in myometrial cells. Role of polypeptide growth factors : Epidermal GF, Insulin-like GF Transforming GF stimulate the growth.
  5. 5. UTERINE FIBROIDS Body Interstitial / Intramural Subserous Subserous Pseudo Parasitic Submucous Sessile Peduncalate d Cervical Anterior Posterior Central Lateral
  6. 6. Types of Uterine Fibroids
  7. 7. Pathology  Naked eye appearance: Enlarged uterus, distorted shape. Firm appearance on touch. Cut section : Smooth, whitish, whorled and trabeculation. False capsule formation. Periphery is more vascular.
  8. 8. Cut section of Uterine Fibroid
  9. 9. Secondary changes in fibroids:  Degeneration  Atrophy  Necrosis  Infection  Vascular changes  Sarcomatous changes
  10. 10. Clinical features  Asymptomatic  Menstrual abnormalities menorrhagia, metrorhhagia  Dysmenorrhoea  Dyspareunia  Infertility  Recurrent pregnancy loss  Abdominal enlargement  Pelvic pain
  11. 11. Investigations  USG Pelvis, TVS  MRI  HSG  Hysteroscopy  Uterine curettage
  12. 12. Management of Uterine Fibroids Symptomatic Medical Surgery Myomectomy Hysterectomy Myolysis Embolothera py Asymptomati c Regular supervision Surgery
  13. 13. Medical Management Objectives :  To improve menorrhagia  To correct anaemia  To reduce vascularity and size of tumour  To postpone surgery
  14. 14. Drug Therapy  Antiprogesterones (Mifeprestone)  Danazol  GnRH analogues  LNG-IUS  Prostaglandin synthetase inhibitors.
  15. 15. Surgical Management of Uterine Fibroids  Myomectomy  Embolotherapy  Hysterectomy
  16. 16. Cervical Fibroids Symptoms :  Anterior Cervical Fibroids  Posterior Cervical Fibroids  Lateral Cervical Fibroids  Central Cervical Fibroids
  17. 17. Treatment  Supravaginal cervix : Myomectomy  Infravaginal cervix : a. Sessile tumour : Myomectomy b. Pedunculated tumour : Polypectomy

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