European Journal of Molecular & Clinical Medicine

INTRODUCTION-uterine fibroids are common tumor of uterus, seen in reproductive age group. Fibroids during pregnancy produce special challenges during labour. Small fibroids with minimal symptoms treated with medical management, while large, multiple fibroids with pressure symptoms require surgical management. Fibroids during pregnancy produces special challenges during labour.
AIMS & OBJECTIVES –To study and analyse the Risk factors associated withfibroids, Clinical features according to different type offibroid, Different types of management of fibroid.
METHODOLOGY- fibroid cases were diagnosed clinically and with ultrasonography. Details of clinical examination findings, investigations and treatment modalities used were noted. Difficulties during surgery and methods to overcome were studied.
Histopathology details of specimen and other associated findings were studied.
RESULTS- Fibroids are Commonly seen in reproductive age group showing 45.5% cases. Majority cases are multipara seen in 79.35% cases and 5.14% cases are pregnant patients with fibroid. Intramural fibroid was seen in 60% and presented with menorrhagia (73%) and dysmenorrhea (50.5%). Fibroids presented with menstrual symptoms were seen in 96.15% cases. 61.7% cases underwent surgical management in that Total Abdominal Hysterectomy alone constitute 76.19%. neglected fibroids were common in rural areas making surgical management more common.
CONCLUSIONS- Pre-operative adequate preparations with general build-up for anesthesia and surgery, imaging studies, ureteric stenting where-ever required, use of GNRH analogues and following the principles of Fibroid surgery, made successful surgeries with no surgical morbidity and mortality. Caesarean section is common mode of delivery in fibroids in pregnancy with no complications.

Background:Global prevalence of abnormal uterine bleeding (AUB) ranges from 3%-30% among women 15-45 years. It is necessary to rule out any pathological condition that may be responsible for AUB so that it can be corrected at the earliest.
Objective:To study and review various causes, diagnostic and treatment modalities in evaluating abnormal uterine bleeding
Methods:Hospital based cross sectional study was carried out among 240 women with AUB. History, examination, USG pelvis and relevant examination was carried out. PALM-COEIN criteria was used to classify AUB. Appropriate management was followed.
Results:Prevalence of AUB was 19%. Majority belonged to 31-40 years. 21.7% had hypertension. Majority (58.3%) presented with heavy menstrual bleeding. 60% had AUB for 3-6 months.Per speculum examination showed that 11.7% had polyp and 22.1% had cervical erosions. On per vaginal examination, 52.9% had bulky uterus. On USG examination, 23.8% were found to have fibroids.Most common histopathological diagnosis was proliferative phase in 19.6% of the cases.55% of the women were found to have polyp followed by leiomyoma in 25% of the cases as per PALM criteria while as per COEIN criteria, most common cause of AUB was endometrial in 21.3% of the cases followed by ovulatory in 13.8% of the cases.70% cases of AUB could be managed conservatively while surgery was required in 27.9% of the cases; however, five cases resolved without any sort of intervention.
Conclusion:Prevalence of AUB was high in the study population. Age 31-40 years, associated co-morbidities, obesity and lower-class women had higher prevalence of AUB. It can be managed conservatively in most of the cases.