FIBROMYOMA (FIBROIDS)

Is also known as Uterine Fibroid and they are benign smooth muscle tumors of the uterus. Most women have no symptoms while others have painful and heavy bleeding. If large enough, it can start resting on the bladder causing the woman to urinate. They may cause painful back pain and or pain during sexual intercourse. It can be one instance or many. It occasionally makes pregnancy difficult. Other symptoms include uterine leiomyoma, uterine myoma, fibro leiomyoma.

CAUSES

The causes are unknown

RISK FACTOR

It can occur in women between the ages of 20-50 years due to the following: –

1. DIET:- A diet high in fruit and vegetables tends to lower the risk of developing fibroids. It is unclear if other fiber, vitamin A, C and E and Phytoestrogens, carotenoid, milk, and dairy products have any effect
2. GENETICS:- 50% of uterine fibroids often demonstrates a genetic abnormality, or there is a genetic link and translocation is found in some chromosomes and fibroids. If a mother had fibroids, the risk in the daughter is about 3 times higher than the average.
3. FAMILIAL LEIOMYOMATA:- Also known as Reed’s Syndrome that causes uterine leiomyoma along with cutaneous leiomyoma and renal cell cancer. This is also associated with a mutation of the gene that produces the fumarate hydration located in the long arm of chromosome inheritance.

PATHOPHYSIOLOGY

The main cause of fibroids therefore remains unknown, but research shows that it is usually as a result of hormonal imbalance, which then proliferates in excess layers causing severe contraction of abdominal muscles, that results in pain, when the blood vessels around the muscles are affected, there is usually bleeding, if there is no prompt medical intervention the patient bleeds profusely, develops anemia and that can lead to death.

Since fibroids are an abnormal growth in the uterus, they can interfere with the growth and position of a baby in the uterus and that can result in premature labour and also distension of the abdomen.

SIGNS AND SYMPTOMS

Painful or excessive flow of blood due to contraction of the abdominal muscle.

Abdominal pain
Anaemia
Pain during sexual intercourse (dyspareunia)
Premature labour
Interference with the position of the baby

DIAGNOSTIC MEASURES AND TEST

HISTORY TAKING: about disorder on menses, about family history, and the obstetric history of fertility by the doctor.
PHYSICAL EXAMINATION: Abdominal palpation, auscultation especially if there is a baby in the uterus.

• ABDOMINAL SCAN:- the view of the tumors
• TISSUE BIOPSY:- a tissue is taken for histology test
• FULL BLOOD COUNT:- the test is done to know
• PREGNANCY TEST:- To check if the individual is pregnant and to know the condition of the baby in the uterus.

MEDICAL MANAGEMENT

1. Drugs Like:
   Danazol and cabergoline help to string the fibroid tumor.
   Levonorgestrel is used for hormonal therapy.
2. UTERINE ARTERY EMBOLIZATION:- is a non-invasive procedure that blocks blood supply to the fibroids.

SURGICAL MANAGEMENT

Myomectomy-surgical removal of the fibroid.
Hysterectomy-surgical removal of the uterus.