L eiomyoma Classification of Uterine - PowerPoint Presentation

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Uploaded On 2022-06-18

L eiomyoma Classification of Uterine - PPT Presentation

Leiomyomas Diagnosis Leiomyomas are often detected by pelvic examination with findings of uterine enlargement irregular contour smooth outlines freely mobile uterus In reproductiveaged women uterine enlargement should prompt determination of a urine or serum ID: 920338

myoma uterine fibroid case uterine myoma case fibroid intramural year treatment female presents abdominal weeks pregnant examination diagnosis leiomyomas

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Slide1

Leiomyoma

Slide2

Slide3

Classification of Uterine Leiomyomas

Slide4

Slide5

Diagnosis

Leiomyomas

are often detected by pelvic examination with findings of uterine enlargement, irregular contour, smooth outlines, freely mobile uterus.

In reproductive-aged women, uterine enlargement should prompt determination of a urine or serum -

hCG

level.

Slide6

Transvaginal sonogram of an intramural leiomyoma with calcified border

Slide7

Submucous fibroid clearly outlined by saline-infusion sonography and identified by long white arrows. The SIS catheter balloon is indicated by the short white arrow

Slide8

Added value of transvaginal ultrasound (top row) and hydrosonography (bottom row), here in the case of a type

submucous

myoma

Slide9

Slide10

Case 1:

A 34-year-old female pregnant 28 weeks presents with acute abdominal pain that is continuous for the previous 2 days. Examination: temp.37.8 Co , PR 100bpm, B.P. 110\80mmHg. Abdominal exam. SFH 34 weeks with max tenderness over the uterine

fundus

, fetal heart 140

bpm

What is your provisional diagnosis

How would you confirm the diagnosis

Mention the treatment of this case

Slide11

Clinical findings of red degeneration include focal pain, tenderness on palpation, and sometimes low-grade fever and leukocytosis. On occasion, the parietal peritoneum overlying the infarcted myoma becomes inflamed and a peritoneal friction rub develops.

Slide12

Myoma degeneration may be difficult to differentiate from appendicitis, placental abruption, ureteral stone, or pyelonephritis, and imaging techniques aid in discrimination.

Treatment

of symptomatic

myomas

consists of analgesia and observation. Most often, signs and symptoms abate within a few days, but inflammation may stimulate labor. Surgery is rarely necessary during pregnancy.

Slide13

Note:Regardless of their size, asymptomatic leiomyomas usually can be managed expectantly by annual pelvic examination

Slide14

Case 2:A 34-year-old newly married female presents with lower abdominal mass. Abd. Exam: uterine size 22weeks. U\S revealed an intramural fibroid 10*12 cm.

What is your

preconceptional

counseling for this patient

Slide15

After 1 year the same patient presents to you because she is not getting pregnant yet.What is your treatment ?

Slide16

Case 3:a 28-year-old female pregnant 40 weeks with a breech presentation. At caesarean section a uterine myoma was found at the lower uterine segment.

What is your decision concerning the uterine

myoma

Slide17

Slide18

Laparoscopic myomectomy, Hysterotomy of a posterior intramural fibroid

Slide19

Visualization of the myoma after opening of the pseudocapsule

Slide20

Enucleation of the myoma

Slide21

End of the myomectomy

Slide22