FIBROID UTERUS

Fibroid is a commonest benign  tumor in females . It is seen in 20% of women. Most of them do not show any symptoms highest incidence is between the ages of 35-45 years.

Development of fibroid has positive family history and also sense genetic abnormalities also have a role in development of fibroids. The rate of growth of fibroid is slow and it takes about 3-5years for the fibroid to grow sufficiently to be felt per abdomen.
Risk factors for development of fibroid are :

  1. Nulliparity
  2. Obesity
  3. Hyperoestrogenic state
  4. Blacks

Fibroids are been less frequently in multiparous women. Fibroids grows rapidly  during pregnancy or also among oral contraceptive pill users. Most common type of fibroid is intramural type

Symptoms – 75% of women are asymptomatic.

  1. Excessive bleeding during menses
  2. Frequent menstrual cycles
  3. Dysmenorrhea
  4. infertility – scan in 30% of women having fibroids.

During pregnancy it can cause abortion , preterm labour and also growth restriction in fetus . it can also cause.

Postpartum Hemorrhage

If the fibroid size is very big and impacted it can cause pressure symptoms like constipation, retention of urine . Fibroids can be treated medically and surgically. Patients with fibroid uterus can be given medications for reducing the amount of bleedind and antispasmedics to relive pain and dysmenorrhea. GNRH against are also prior to sugery in cases of huge and multiple fibroids.

Newer modalities of medical therapy are LNG-IUS which is levonorgestrel releasing intrauterine system. It is a harmone releasing device like copper-t . This reduces uterine size and bleeding. Ullipristal acetate is the newest drug available in market for fibroid uterus . this is given for a continuous period of 3months which shrinks size of fibroids.

Surgically only fibroids can be removed which is called as myomectomy. This surgery is a fertility of uterus preserving surgery done in younger age group of females. If family completed and elderly women hysterectomy can be done .

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