What is this - fibroids of the uterus is a benign tumor that affects the muscular layer of the uterus.
According to statistical data, its prevalence reaches 70%, therefore it is considered the second disease in frequency after the inflammatory processes of the organs of the reproductive system.
The danger of the disease lies in the fact that as a result of common etiopathogenetic mechanisms, it is very often combined with hyperplastic endometrial processes. And they, in turn, are the background for the development of endometrial cancer. The uterine myoma only in 1% of cases can become malignant, turning into sarcoma.
Causes of the occurrence of fibroids
The reasons that lead to the development of uterine fibroids have not been fully determined yet.earlier it was suggested that the whole thing is in the increased level of estrogens.
However, at the modern level of medical development it became clear that hyperestrogenemia is just one of the elements of the pathological chain. Statistical studies have made it possible to identify predisposing factors on the basis of which women are considered at risk for developing uterine fibroids. These factors are:
endometritis - inflammatory lesion of the inner layer of the uterus with damage to its receptors
wearing of intrauterine spirals
hysteroscopy
separate diagnostic curettage of the uterus and cervical channel
anovulation.
All this explains the frequent detection of uterine myomas in women of reproductive age who have the above risk factors. A tumor rarely occurs before the onset of sexual activity. In the menopausal age there is a regression of the myomatous nodes due to the lack of hormonal influences.
However, during pregnancy there is an intensive growth of tumor rudiments with all the ensuing adverse effects.
Symptoms of fibromioma
For a long time, uterine fibroids can go on without symptoms. But over time certain clinical manifestations develop:
pain in the lower abdominal part
urination disorder
stool rest
bleeding from the uterine cavity
prolonged and profuse menstruation, etc.
Diagnosis of the disease is based on the evaluation of clinical symptoms, vaginal examination data, ultrasound screening.
Fibromyoma of the uterus and pregnancy
Fibromyoma of the uterus leaves an imprint on the course of pregnancy. Against this background, certain complications may develop:
1) The threat of abortion - spontaneous abortions and premature births
2) Placental insufficiency - the placenta can not fully perform all the functions assigned to it
3) Fetal development retardation syndrome when the child lags behindits development
4) Chronic intrauterine hypoxia of the fetus, when the child does not receive oxygen in full, which leads to the defeat of internal organs.
Some complications may develop during childbirth:
1) Abnormalities of labor - weakness of labor, discordination
2) Acute intrauterine hypoxia
3) Premature abruption of the placenta.
In the postpartum period, the risk of bleeding increases because of a breach of the uterine contractility.
Diagnosis of fibroids
Diagnostic search for uterine myomas is to conduct the following additional investigation methods:
1) Ultrasound examination, which makes it possible to determine where the myomatous nodes are located, the state of the uterine cavity, including the endometrium, the condition of the ovaries
. 2) Metrosalpingography is an X-ray examination that involves evaluating the state of the uterus and fallopian tubes. It is especially valuable if a woman with a fibroids can not become pregnant.
3) Histological examination of scrapes obtained by separate diagnostic curettage. This study allows eliminating the pathology of the endometrium, which often accompanies the fibroids of the uterus.
However, the preliminary diagnosis of an obstetrician-gynecologist is based on a vaginal examination. In fibroids, it is characterized by the following diagnostic features:
uterine enlargement in size
palpation of nodes, which causes tuberosity of the uterus
dense consistency of the uterus
uterine deviation in one direction or another.
Treatment of fibroids
Treatment of uterine fibroids can be both conservative and operative. Conservative treatment is performed with a fibroids size of no more than 8 weeks.
Within its framework, hormonal drugs are prescribed from the following groups:
gonadoliberin agonists
antigonadotropins
pure gestagenes
combined oral contraceptives.
Operative treatment of fibroids can be both organ-preserving and radical. The latter includes the removal of the uterus, which is carried out for certain indications. Organ-preserving treatment is a conservative myomectomy.
Recently, new technologies have been used that allow reproductive function to be maintained. These methods include uterine artery embolization. The essence of the method is that special silicone emboli are introduced into the uterine artery, which disrupt the blood supply to the myomatous nodes.
Over time, necrosis of nodes and resorption of necrotic tissue occurs. This is accompanied by a slight increase in body temperature and other signs of intoxication. Usually, for the relief of these signs, the use of non-steroidal anti-inflammatory drugs is indicated.
Prevention of
The preventive measures for fibromioma are as follows:
1) Contraception for the prevention of abortion as a method of abortion
2) Regulation of the menstrual cycle with its violation
3) Discarding the use of intrauterine contraceptives
4) Prevention of pelvic inflammatory complications
5) Thorough evaluation of the indications before the diagnostic curettage.
However, effective preventive measures that would reliably reduce the incidence of this pathological process have not yet been developed.
In conclusion, it should be noted that uterine myoma is the most common tumor of the reproductive system of a woman. The reasons for its development have not been finally established, which explains the difficulties in the therapy of this condition. For a long time, the uterine myoma has not been clinically manifested, but the pathological process has progressed.
Therefore, in order to timely detect it requires regular observation at the gynecologist.
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