Uterine fibroids
Download as PPTX, PDF437 likes390,884 views
Uterine fibroids are benign tumors that originate from the smooth muscle layer of the uterus. While the exact causes are unknown, risk factors include heredity, race, pregnancy, and obesity. Uterine fibroids can cause menstrual abnormalities, infertility, pain, and pressure symptoms. Diagnosis involves ultrasound, biopsy, or hysteroscopy. Treatment options depend on symptoms but may include medications, uterine artery embolization, myomectomy (surgical removal of fibroids), or hysterectomy.
Uterine fibroids
- 2. DEFINITION • Uterine fibroid is a leiomyoma (benign (non- cancerous) tumor from smooth muscle tissue) that originates from the smooth muscle layer (myometrium) of the uterus
- 3. CAUSES • unknown. • Family history • Genetic alterations. • Hormones. • Other chemicals.
- 4. RISK FACTORS • Heredity. • Race. • Pregnancy and childbirth. • Nulliparity Obesity • Oral contraceptives.
- 5. TYPES • BODY OR CORPOREAL FIBROIDS • Intramural or interstitial fibroids • Subserosal fibroids • Submucosal fibroids
- 6. • CERVICAL FIBROIDS 1-2 %
- 7. SECONDARY CHANGES IN FIBROID • Degenerative changes • Hyaline degeneration: • Cystic degeneration: • Calcification: • Fatty degeneration: • Red degeneration: • Septic degeneration:
- 8. • Infection • Atropy • Necrosis • Vascular changes • Sarcomatous changes
- 9. CLINICAL FEATURES • 75 % remains asymptomatic • Menustrual abnormalities – Menorrhagia (30%) – Metrorrhagia or irregular bleeding
- 10. • Dysmenorrhea • Infertility(30%): • Pain lower abdomen • Abdominal swelling (lump) • Pressure symptoms
- 11. • Abdominal examination • Feel is firm more towards hard may be cystic in cystic degeneration. • Margins are well defined except the lower pole. • nodular may be uniformly enlarged • Mobility is restricted from above downwards but can be moved from side to side. • Percussion : swelling is dull
- 12. • Pelvic examination • Bimanual examination reveals uterus irregularly enlarged • Uterus is not felt separated from the swelling and as such a groove is not felt between the uterus and the mass. • The cervix moves with the movement of the tumour felt per abdomen.
- 13. DIAGNOSIS • An abdominal, transvaginal or pelvic ultrasound • An endometrial biopsy • A hysteroscopy • Hysterosalpingography • Laparoscopy
- 14. TREATMENT • For symptomatic fibroids • Medication to control symptoms • Medication aimed at shrinking tumours • Ultrasound fibroid destruction • surgically aided methods to reduce blood supply of fibroids • Myomectomy or radio frequency ablation • Hysterectomy • Treatment for infection and anemia • Embolization
- 15. Medications • Oral contraceptive pills • GnRH agonists • The antihormonal drug RU-486 (mifepristone) • Danazol (Danocrine) • Antifibrinolytics (tranexamic acid) • Nonsteroidal anti-inflammatory agents • Progesterone receptor modulator named Ellaone
- 17. • Uterine artery embolization, • Uterine artery ligation • Radio frequency ablation • Endometrial ablation
- 18. COMPLICATIONS • Menorrhagia. • Abdominal pains • Premature birth, labor problems, miscarriages • Infertility
- 19. • Leiomyosarcoma • Twisting of the fibroid • Anemia • Urinary tract infections • A c-section may be needed • Some pregnant women with fibroids have heavy bleeding immediately after giving birth.
- 20. NURSING DIAGNOSIS • Acute pain related to post operative wound as manifested by facial expression and pain scale score • Imbalanced nutrition less than body requirements related to pain as manifested by decreased food intake.
- 21. • Impaired bowel elimination , constipation related to decreased activity, pain on straining • Disturbed sleep pattern related to pain and hospitalization • Risk for infection related to the surgery • Low Self-Esteem related to changes in femininity as evidenced by Withdrawal, depression