Frequency of Uterine Leiomyomas in Multipara Women: Frequency of Uterine Leiomyomas in Multipara Women

Fatima  Latif; Akash  John; Abid  Ali; Rehan  Afsar; Iqra  Ashfaq

doi:10.54393/pjhs.v3i01.55

Authors

Fatima Latif University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat, Campus
Akash John The University of Chenab, Gujrat
Abid Ali Department of Allied Health Sciences, The University of Chenab, Gujrat
Rehan Afsar The University of Chenab, Gujrat
Iqra Ashfaq University Institute of Radiological and Medical Imaging Sciences, The University of Lahore, Gujrat, Campus

DOI:

https://doi.org/10.54393/pjhs.v3i01.55

Keywords:

Uterine Fibroids, Leiomyomas, Frequency, Sonography, Multipara

Abstract

Fibroids are typically well-defined solid masses that have a convoluted appearance. These are generally echogenic like the myometrium, though sometimes they can indeed be hypoechoic. Objective: To determine the incidence of uterine leiomyomas in multipara women in Gujranwala, Pakistan. Methods: A cross-sectional study was conducted at the diagnostic department of radiology (DHQ/Teaching Hospital, Gujranwala). The study lasted for three months, from February 24, 2022, to May 24, 2022. A total of 140 people participated in the research after written informed consent. 140 multiparous women with uterine fibroids were included between the mentioned dates. The examination of the patients included pelvic ultrasonography with a full bladder. Results: This survey consisted of 140 multiparous women. 100 (64.1%) of 140 females having fibroid uterus who reported to the gynaecology department exhibited submucosal fibroids, 33 (21.2%) contained intramural fibroids, and 23 (14.7%) of them had subserosal fibroids. Fibroids with 127 (81.4%) in the anterior and 29 (18.6%) in the posterior were observed. Menstrual inconsistency was the most prevalent clinical presentation of reported cases, featuring menorrhagia in 105 (75%) patients, polymenorrhagia in 24 (17.1%) patients, and abdominal discomfort in 44 (31.4%) patients, and urinary frequency in 29 (27.9%) women. A total of 47 (33.6%) of the females had a family background of uterine fibroids. Conclusion: Submucosal fibroids are the most abundant, followed by intramural and subserosal fibroids, with pedunculated fibroids being the least frequent. The anterior part of the uterus is the most probable site of fibroid emergence. Menorrhagia was the most prevalent symptom.

References

Wynn R, editor. Biology of the uterus. Springer Science & Business Media; 2013 Jun.

Ellis H. Anatomy of the uterus. Anaesthesia & Intensive Care Medicine. 2011 Mar; 12(3):99-101. doi: 10.1016/j.mpaic.2010.11.005.

Wray S. Insights into the uterus. Experimental Physiology. 2007 Jul; 92(4):621-31. doi: 10.1113/expphysiol.2007.038125

Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology. 2017 Sep; 124(10):1501-1512. doi: 10.1111/1471-0528.14640.

Asada H, Yamagata Y, Taketani T, Matsuoka A, Tamura H, Hattori N, et al. Potential link between estrogen receptor-alpha gene hypomethylation and uterine fibroid formation. Molecular human reproduction. 2008 Sep; 14(9):539-45. doi: 10.1093/molehr/gan045.

Khan AT, Shehmar M, Gupta JK. Uterine fibroids: current perspectives. International Journal of Women's Health. 2014 Jan; 6:95-114. doi: 10.2147/IJWH.S51083.

Ciavattini A, Clemente N, Delli Carpini G, Di Giuseppe J, Giannubilo SR, Tranquilli AL. Number and size of uterine fibroids and obstetric outcomes. Journal of Maternal, Fetal, and Neonatal Medicine. 2015 Mar; 28(4):484-8. doi: 10.3109/14767058.2014.921675.

Stewart EA. Uterine fibroids. Lancet. 2001 Jan ; 357(9252):293-8. doi: 10.1016/S0140-6736(00)03622-9.

Donnez J, Dolmans MM. Uterine fibroid management: from the present to the future. Human Reproduction Update. 2016 Nov; 22(6):665-686. doi: 10.1093/humupd/dmw023.

Lethaby A, Vollenhoven B. Fibroids (uterine myomatosis, leiomyomas). American Family Physician. 2005 May; 71(9):1753.

Gross KL, Morton CC. Genetics and the development of fibroids. Clinical Obstetrics and Gynaecology. 2001 Jun; 44(2):335-49. doi: 10.1097/00003081-200106000-00020

De La Cruz MS, Buchanan EM. Uterine Fibroids: Diagnosis and Treatment. American Family Physician. 2017 Jan; 95(2):100-107.

Stoelinga B, Huirne J, Heymans MW, Reekers JA, Ankum WM, Hehenkamp WJ. The estimated volume of the fibroid uterus: a comparison of ultrasound and bimanual examination versus volume at MRI or hysterectomy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015 Jan; 184:89-96. doi: 10.1016/j.ejogrb.2014.11.011.

Ibrar F, Riaz S, Dawood NS, Jabeen A. Frequency of fibroid uterus in multipara women in a tertiary care centre in Rawalpindi. ournal of Ayub Medical College Abbottabad. 2010 Sep; 22(3):155-7.

Deveer M, Deveer R, Engin-Ustun Y, Sarikaya E, Akbaba E, Senturk B, et al. Comparison of pregnancy outcomes in different localizations of uterine fibroids. Clinical and experimental obstetrics & gynecology. 2012 Dec; 39(4):516-8.

Evans P, Brunsell S. Uterine fibroid tumors: diagnosis and treatment. American family physician. 2007 May; 75(10):1503-8.

Tranquart F, Brunereau L, Cottier JP, Marret H, Gallas S, Lebrun JL, et al. Prospective sonographic assessment of uterine artery embolization for the treatment of fibroids. Ultrasound in Obstetrics and Gynaecology. 2002 Jan; 19(1):81-7. doi: 10.1046/j.0960-7692.2001.00535.x

Hurst BS. Uterine fibroids. InUltrasound imaging in reproductive medicine. Springer, Cham. 2019: 137-53.

Benaglia L, Cardellicchio L, Filippi F, Paffoni A, Vercellini P, Somigliana E, Fedele L. The rapid growth of fibroids during early pregnancy. PLoS One. 2014 Jan; 9(1):e85933. doi: 10.1371/journal.pone.

Capezzuoli T, Vannuccini S, Fantappiè G, Orlandi G, Rizzello F, Coccia ME, Petraglia F. Ultrasound findings in infertile women with endometriosis: evidence of concomitant uterine disorders. Gynaecological Endocrinology. 2020 Sep; 36(9):808-812. doi: 10.1080/09513590.2020.1736027.

Bulun SE. Uterine fibroids. New England Journal of Medicine. 2013 Oct; 369(14):1344-55. doi: 10.1056/NEJMra1209993.

Wilde S, Scott-Barrett S. Radiological appearances of uterine fibroids. Indian Journal of Radiology and Imaging. 2009 Sep; 19(3):222-31. doi: 10.4103/0971-3026.54887.

Walker CL, Stewart EA. Uterine fibroids: the elephant in the room. Science. 2005 Jun; 308(5728):1589-92. doi: 10.1126/science.1112063.

Levy BS. Modern management of uterine fibroids. Acta obstetricia et gynecologica Scandinavica. 2008; 87(8):812-23. doi: 10.1080/00016340802146912.

Dvornyk V. Significant interpopulation differentiation at candidate loci may underlie ethnic disparities in the prevalence of uterine fibroids. Journal of Genetics. 2021; 100:90.

Al-Hendy A, Myers ER, Stewart E. Uterine Fibroids: Burden and Unmet Medical Need. Seminars in Reproductive Medicine. 2017 Nov;35(6):473-480. doi: 10.1055/s-0037-1607264.

Okogbo FO, Ezechi OC, Loto OM, Ezeobi PM. Uterine Leiomyomata in South Western Nigeria: a clinical study of presentations and management outcome. African Health Sciences. 2011; 11(2).

Gambone JC, Reiter RC. Nonsurgical management of chronic pelvic pain: a multidisciplinary approach. Clinical Obstetrics and Gynecology. 1990 Mar; 33(1):205-11. DOI: 10.1097/00003081-199003000-00026

Abraham R. Uterine fibroids. In: Manual of clinical problems in Obstet Gynaecol 4th (ed). 1994: 227–9.

Zhang L, Chen WZ, Liu YJ, Hu X, Zhou K, Chen L, Peng S, Zhu H, Zou HL, Bai J, Wang ZB. Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus. European journal of radiology. 2010 Feb; 73(2):396-403. doi.org/10.1016/j.ejrad.2008.11.002

Chen J, Chen W, Zhang L, Li K, Peng S, He M, Hu L. Safety of ultrasound-guided ultrasound ablation for uterine fibroids and adenomyosis: a review of 9988 cases. Ultrasonics sonochemistry. 2015 Nov; 27:671-6. doi.org/10.1016/j.ultsonch.2015.05.031

Ciebiera M, Włodarczyk M, Słabuszewska-Jóźwiak A, Nowicka G, Jakiel G. Influence of vitamin D and transforming growth factor β3 serum concentrations, obesity, and family history on the risk for uterine fibroids. Fertility and Sterility. 2016 Dec; 106(7):1787-92. doi.org/10.1016/j.fertnstert.2016.09.007