Fibroid Uterus Treatment in Maldives
Fibroids are also called Myoma or leiomyoma Fibroids occur in 50–60% of women by the age of 40yr. The chance of having fibroid increases with age.
When to suspect presence of fibroid in uterus ?
Heavy bleeding and/or pain during periods. Pressure symptoms due to large size of myoma causing pain/difficulty in passing urine, constipation, pain during bowel motion. Pregnancy complications like abortion, preterm labour, pain etc.
How fibroid can affect fertility ?
Presence of fibroid can reduce fertility due to following effects :
- Direct pressure over uterine cavity & fallopian tubes.
- Change in direction of uterine cavity & fallopian tube.
- Change in receptivity of lining of uterus.
- Change in direction of normal Junctional zone contraction waves.
- Recurrent Implantation Failure.
How fibroid can affect pregnancy ?
Presence of fibroid can have following adverse effects on pregnancy :
- Risk of abortion.
- Risk of preterm labour pain (delivery before 9 month)
- Intra uterine growth restriction (low birth weight baby)
- Wrong position of baby in uterus (Malpresentation)
- Rupture of water bag before delivery date (PROM)
- Separation of placenta from uterus (Abruption)
- More chances of delivery by caesarean section
How is fibroid treated ?
In women planning to conceive options are :
- Myomectomy : Surgery to excise the fibroids
- Medical management : Drugs like GnRH agonist & SPRM( selective progesterone receptor modulator ) to shrink the fibroid away from uterine cavity
- No treatment : It is chosen if fibroid is unlikely to affect fertility & pregnancy.
Who should undergo surgery to remove fibroid (myomectomy) ?
It’s a very individualised decision as fibroids are very commonly seen in otherwise fertile women also. The decision to remove fibroid is based on detailed fibroid mapping , using 2d & 3D USG to assess the following :
- Location of fibroid -those towards cavity should be removed
- Size of fibroid – larger than 4 cm should be removed
- Number of fibroids – 2 or more in number are better removed
- Closeness to the lining of uterus – Cavity distorting fibroid should be removed.
What to expect after fibroid removal?
- Couple can start trying for pregnancy after 2-3 month.
- After myomectomy delivery by caesarean section is recommended.
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