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Family history
Obesity
AETIO-PATHOLOGY
Ovarian Hormones;
Estrogen stimulation of EGF receptors
Progesterone stimulation of EGF &
stimulation of AIP
Ovarian suppression;
↓Metalloproteinase inhibitory activity
↑Metalloproteinase matrix
Reduced expression of growth Inhibitory
Factors;
Monocyte chemotatic protein-1
Monoclonal expansion
Single or multiple
Spherical in shape, lobulated cut surface with a
TYPES/SITES
Submucous
Intramural
Subserosal
Pedunculated submucosal
Pedunculated abdominal
Parasitic
Cervical
Intraligamentous
CLINICAL FEATURES
SYMPTOMS
2. Asymptomatic
3. Abnormal uterine bleeding
4. Abdomino-pelvic mass
5. Pain
6. Pressure effects; bladder, ureter,
GIT, veins, nerves, pancreas,
deep dyspareunia
7. Subfertility
EXAMINATIONS
PHYSICAL SIGNS
GENERAL EXAM
ABDOMINAL EXAM
BIMANUAL EXAM
COMPLICATIONS OF
FIBROIDS
Torsion
Haemorrhage
Ascitis; Pseudo-Meigs’ syndrome
Infection
Degeneration;
Hyaline
Cystic
Red degeneration
Calcification
Malignant change
FIROIDS AND
PREGNANCY
Abortions
Premature labour
Malpresentation
Malpositions
Obstructed labour
Abnormal uterine action
Post partum Haemorrhage
DIFFERENTIAL
DIAGNOSIS
PREGNANCY
OVARIAN TUMORS
TUBO-OVARIAN ABSCESS/NEOPLASIA
LEIOMYOSARCOMA
ADENOMYOSIS
ENDOMETRIOSIS
ENDOMETRIAL CARCINOMA
CONGENITAL ABNORMALITIES
INVESTIGATIONS
FBC
URINALYSIS & URINE M/C/S
INTRACERVICAL SWAB M/C/S
S/E/U/Cr
U.S.S.
ABD. X-RAY
INTRAVENOUS UROGRAPHY
HYSTEROSALPINGOGRAPHY
SALINE SONOHYSTEROGRAPHY
EUA & ENDOMETRIAL BIOPSY
MAGNETIC RESONANCE IMAGING
HYSTEROSCOPY
LAPAROSCOPY