Lecture of uterine fibroids and pregnancy

2021-03-20 12:00 AM

Fibroids: can also be seen in cases of sub-peritoneal fibroids. The sclerosis symptom is similar to the stem helix of the ovarian cyst

The encounter rate ranges from 5 to 20%.

Effect of uterine fibroids on pregnancy

Infertility

There are currently no exact rates of infertility caused by fibroids, but fibroids definitely cause infertility.

A large fibrous nucleus at the corner of the uterus presses on the ovary, stretching and squeezing the fallopian tube, causing the phenomenon of "muscle block", preventing sperm from meeting the ovule.

Massive fibrous nucleus under the mucosa, filling the uterus, eggs no longer nesting place so miscarriage very soon.

During pregnancy

Early miscarriage: when the fibrous nucleus has not occupied the entire uterine chamber, the embryo still implants and develops for a while. When the pregnancy is grown, the uterus is stimulated, contractions and the fetus ejected, early miscarriages usually occur in the first trimester.

Late miscarriage: usually occurs in the second trimester. The fibroids only occupy a part of the uterus, when the fetus is large, it will stimulate and come out.

Premature: occurring at the gestational age of 7 months or more, at this time the fetus is too big, stretching the uterus, stimulating birth. There are also times when a large fibroid is pressed into the uterus, causing a miscarriage or premature birth.

Fibroids: can also be seen in cases of sub peritoneal fibroids. Fibrocystic stem torsion resembles a stem helix of an ovarian cyst and is often misdiagnosed with an ovarian cyst. Fibrosis can stimulate the uterus to contract or require emergency surgery to easily cause miscarriage or preterm delivery.

During labor

Disorder of labor contractions: because the fibrous nucleus prevents the conduction of the contraction, sometimes makes the contraction reverse, resulting in prolonged labor leading to fetal failure.

Prostorial tumors: Small fibroids, located in the uterine waist, or fibroids with long stalks, fall to the waist of the uterus to form a leading tumor, preventing the progression of the fetus, causing difficulty in childbirth.

Prevent vegetable peeling due to contraction disorder, so vegetables are not completely peeling, causing vegetables to be omitted.

Also due to a contraction disorder, the uterus does not contract well, leading to uterine sputum causing bleeding during the period of vegetable peeling or after vegetables.

Infectious necrosis occurs in the postpartum period, with mucosal fibrous nuclei often found.

Effects of pregnancy on fibroids

Pregnancy is often difficult to diagnose except for the fibroids 6cm or more.

Pregnancy increases the level of progesterone excreted by the placenta, which makes the core of the fiber absorbent so it softens, possibly causing indestructible necrosis.

Aseptic necrosis is caused by circulatory insufficiency, so the tumor organization is malnourished. The necrosis starts in the center and then spreads to the top of the tumor.

The patient's uterus is abdominal pain and increasing, but no fever. Local pain in the uterus. If the nucleus is located in the front, it can be seen that the nucleus is a tender mass of pain. Neu lying behind could not see.

An ultrasound is a mass usually located in the wall of the uterus, has a strong resonance, is distinct from the uterine muscle or echogenic sparse, or a heterogeneous echo in the tumour center or in the site of the fibrous nucleus. have necrosis. If bleeding occurs, the anechoic area has an irregular shape, the edge of the necrotic mass is irregular and red or yellow degeneration may occur.

Treatment

During pregnancy

Fibrous stem twisting: emergency surgery, removing twisted fibrous nucleus. When surgery must give uterine contraction drugs at least a week before and after surgery, avoid touching the uterus to avoid stimulation to cause contractions.

Aseptic necrosis: rest, pain relief type that does not affect pregnancy. If there is a fever, it must be treated with antibiotics.

The case m drive caesarean

Partial hysterectomy should only be done if the fibroids are large, or if the fibroids have stalks.

Only small fibrous kernels, 2-3cm in diameter, should not be removed because of the risk of bleeding and postoperative infection.

During pregnancy, surgery only when aseptic necrosis has been actively treated with no results. Management of the fetus depends on the individual patient's condition and requirements.

After surgery, you must also use high-dose antibiotics to fight infections.

In the period of the vegetable loaf

Should peel vegetables, control uterus, inject oxytocin to prevent uterine sputum causing bleeding, if necessary fresh blood transfusion is necessary.

If you have been treated actively after 20-30 minutes, still do not stop bleeding, have to have a hysterectomy, should not hesitate, lose blood a lot will cause blood clotting disorders.