fibroid, myoma, myomectomy, myoma & pregnancy, menorrhagia

1. MYOMA ( FIBROID)
MAGDY ABDELRAHMAN MOHAMED
2015

2. Nomenclature
Fibroid--------Fibroids
Myoma--------Myomata
Fibromyoma—Fibromyomata
Leiomyoma---Leiomyomata

3. • Fibroids (leiomyomas) are benign smooth
muscle cell tumors of the uterus.
• Incidence:
• Commonest tumour in female genital
system.
• More common in low parity, black races.

4. •Described based on location in the
uterus:
• Interstitial: develop from within uterine
wall, do not distort uterine cavity.
• Submucosal: develop from myometrial
cells just below endometrium, often
protrude into and distort uterine cavity.

5. • Subserosal:
protrudes out of serosal surface.
• Cervical: located in the cervix,
rather than uterine corpus.

9. Clinical picture
•Symptoms
• Bleeding.
• Infertility.
• Vaginal discharge.
• Pain.
• Abdominal enlargement.
• Pressure symptoms.

10. Clinical picture
•Signs.
• Pelvi-abdominal mass.
• Bimanual examination.

11. Investigations
• Abdominal & vaginal u/s.
• Saline infusion sonohysterography.
• Hysteroscopy.
• Routine pre-operative investigation.

12. Complications
• Tortion.
• Infection.
• Red degeneration.
• Malignancy (leiomyosarcoma), Very rare.

13. Treatment
• Factors affecting treatment.
• Age.
• Parity.
• Number of fibroid.

14. Treatment
• No symptoms…… no treatment.
• Medical:
• GnRH agonist.
• Correction of anemia

15. Treatment
•Myomectomy.
• Safe, possible & needed.
•Hysterectomy.
•Recent options.
• Uterine artery embolization.
• Focused U/S.

16. Fibroid during pregnancy.
• Increase incidence:
• Abortion
• Preterm labour.
• Pain
• Malpresentation.
• CS.
• Post partum He.

18. Fibroid during pregnancy.
•Myomectomy during CS.
• Contraindicated.
• Done only in rare situations.