Powerpoint presentation on uterine fibroids

1. SEMINAR
ON
UTERINE FIBROIDS
Presented To: Mrs. Bhupinder Kaur
Professor
UCON, Faridkot
Presented By: Simran
M.Sc (N) 2nd Year
UCON, Faridkot

2. INTRODUCTION
Fibroids are the most common benign tumor of the
uterus and also the most common benign solid
tumor in female. Histologically, this tumor is
composed of smooth muscle and fibrous
connective tissue, so named as uterine leimyoma,
myoma or fibromyoma.

3. FIBROIDS
Fibroids are the non-cancerous
growth of the smooth muscles
of the uterus that often appear
during childbearing years.
Sometimes these tumors
become quite large and cause
severe abdominal pain and
heavy periods.

4. OTHER NAMES
Leiomyomas
Myomas
Fibromas
Uterine myomas

5. INCIDENCE
It has been estimated that at least 20% of women at the
age of 30 have got fibroid in their womb.
Almost 50% of them remain asymptomatic.
In colored races (black women), the incidence is even
higher.
These are more common in nulliparous.

6. CONTD…
According to the National Institutes of Health (NIH),
about up to 80 percent of women have them by the age of
50. Fibroids affect around 30 percent of all women by the
age of 35 years, and from 20 to 80 percent by the age of
50 years. However, most women don’t have any
symptoms and may never know they have fibroids
They usually develop between the ages of 16 to 50 years.
These are the reproductive years during which estrogen
levels are higher.

7. DIFFERENT TYPES OF FIBROIDS
Intramural
Fibroids
Subserosal
Fibroids
Pedunculated
Fibroids
Submucosal
Fibroids
Cervical
Fibroids

8. INTRAMURAL FIBROIDS
Intramural fibroids are the
most common type of
fibroid. These types appear
within the muscular wall of
the uterus. Intramural
fibroids may grow larger
and can stretch your womb

9. SUBSEROSAL FIBROIDS
Subserosal fibroids form
on the outside of your
uterus, which is called the
serosa. They may grow
large enough to make your
womb appear bigger on
one side.

10. PEDUNCULATED FIBROIDS
Subserosal tumors can
develop a stem, a slender
base that supports the tumor.
When they do, they’re
known as pedunculated
fibroids.

11. SUBMUCOSAL FIBROIDS
These types of tumors
develop in the middle
muscle layer, or
myometrium, of your
uterus. Submucosal
tumors aren’t as common
as the other types.

12. CERVICAL FIBROIDS
Cervical fibroids take
root in the neck of the
womb, known as the
cervix.

13. CAUSES OF FIBROIDS
Hormones
Pregnancy
Family
History

14. RISK FACTORS FOR FIBROIDS
Increased Risk
 Nulliparity
 Obesity, ↑ body mass index
(BMI), Polycystic ovary
syndrome (PCOS)
 Hyperestrogenic state
 Black women
 High fat diet
 Family history
Reduced Risk
 Multiparity
 Menopause
 Combined oral contraceptives
(COCs) use
 Smoking

15. PATHOPHYSIOLOGY
Due to etiological causes and risk factors
Benign tumors originating in the smooth muscular uterine tissue
Stress with in the myometrium
Simple proliferation of smooth muscle cells
Development of leiomyomas

16. SYMPTOMS OF FIBROIDS
Heavy bleeding between or during your periods that
includes blood clots
Pain in the pelvis or lower back
Increased menstrual cramping
Increased urination
Pain during intercourse

17. Conti….
Menstruation that lasts longer than usual
Pressure or fullness in your lower abdomen
Swelling or enlargement of the abdomen
Other possible symptoms include:
Labour problems
Pregnancy problems
Fertility problems
Repeated miscarriages

18. COMPLICATIONS OF FIBROIDS
1.Menorrhagia 2. Infertility
3. Pregnancy
Problems
4. Abdominal
Pain
5.Leimyosarco
-ma

19. DIAGNOSTIC EVALUATION
History taking
Pelvic examination
Ultrasound
Pelvic MRI
Hysteroscopy
Laparoscopy

20. MEDICAL MANAGEMENT
Gonadotropin-releasing hormone agonist A drug
known as a gonadotropin-releasing hormone
agonist (GnRHa) causes the body to produce less
estrogen and progesterone.
This shrinks fibroids. They may be given before
surgery to shrink the fibroids. GnRH agonists are
for short-term use only

21. Other drugs may be
used, but they may be
less effective when
treating larger fibroids.
NSAIDs
Birth control pills
Levonorgestrel
intrauterine system
(LNG-IUS)
These includes

22. SURGICAL MANAGEMENT
Hysterectomy: A hysterectomy
is the partial or total removal of
the womb. This is considered
for treating extremely large
fibroids or excessive bleeding.
A total hysterectomy can
prevent the return of fibroids.

23. Myomectomy
Surgery to remove very large or
multiple growths may be performed.
This is known as a myomectomy.
An abdominal myomectomy involves
making a large incision in the abdomen
to access the uterus and remove the
fibroids. The surgery can also be
performed laparoscopically, using a
few small incisions into which
surgical tools and a camera are
inserted.

24. Uterine Artery Embolization (UAE)
Cutting off the blood supply
to the area shrinks the fibroid.
Guided by fluoroscopic X-ray
imaging, a chemical is injected
through a catheter into the
arteries supplying blood to any
fibroids.

25. MRI-Guided Percutaneous Laser Ablation
An MRI scan is used to locate the fibroids.
Fine needles are then inserted through the skin and body tissues
of the patient and pushed until they reach the targeted fibroids.
A laser fibre device is inserted through the needles.
A laser light is sent through the device to shrink the fibroids.

26. MRI-Guided Focused Ultrasound Surgery
An MRI scan locates the fibroids, and high energy
ultrasound waves are delivered to shrink them.

27. NURSING MANAGEMENT
Pre-operative care: The client seeks medical help
because of some form of abnormal uterine bleeding,
dyspareunia or pelvic pain.
Obtain a thorough history from patient especially if
there are complaints of irregular bleeding.
It is also important to assess the client’s knowledge of
her condition and the surgery. Listen carefully for any
questions she has sexuality after treatment.

28. PRE-OPERATIVE NURSING DIAGNOSIS
Risk for fluid volume deficit related to heavy mensuration.
Acute abdominal pain related to disease condition.
Activity intolerance related to abdominal distension and
backache.
Altered sleep pattern related to urinary urgency.
Self-care deficit related loss of sexuality after treatment
Deficit knowledge about the treatment and management of
the disease condition

29. POST-OPERATIVE NURSING DIAGNOSIS
Risk for dysfunctional grieving related to loss of
reproductive capacity and perceived loss of femininity.
Acute abdominal pain related to surgical incision.
Risk for fluid volume deficit related to surgical procedure.
Risk for infection related to surgery and secondary to
presence of Foley’s catheter.
Altered nutritional pattern less than body requirements
related to blood loss secondary to less intake of fluid and
food orally pre-operatively.
Constipation related to bowel manipulation during surgery.

30. DISCHARGE INSTRUCTIONS
ACTIVITY
Limit your activity for 2 days after the procedure.
Ask a friend or family member to stay with you as you rest in
bed or on the couch.
Slowly increase your activities during the week after the
procedure.
Don't drive for 24 hours.
Don't climb stairs for 2 days after the procedure.
Don't lift anything heavier than 10 pounds for 1 week after the
procedure.
Don't bend at the waist for 2 days.
Ask your doctor when you can go back to work.

31. OTHER HOME CARE
Don't be alarmed by vaginal discharge that is greyish or brown in
colour. This is from the breakdown of the fibroid tumor. It is normal.
Expect your next 2 or 3 periods to be heavier than normal.
Take your medicines as directed. Don't skip doses.
Unless otherwise directed, drink 6 to 8 glasses of water every day.
This helps to prevent dehydration. It also helps flush your body of the
dye that was used during the procedure.
Take your temperature and check your incision site every day for a
week. Look for signs of infection such as redness, swelling, or
warmth.
Ask your doctor when it is safe to swim or take a bath.

32. REFERENCES
 Suddarths and Brunner,” Textbook of Medical-Surgical Nursing”, Published By-
Wolters Kluwer, Edition: 12th Page No: 1075-1078
 Black M. Jouce,” Medical-Surgical Nursing- Clinical Management For Positive
Outcomes Volume 2”, Published by- W. B. Saunders Company, Edition 6th , Page No-
991-994
 Lemone Priscilla,” Medical Surgical Nursing-Critical Thinking In Client Care,
Edition-4th Published by- Dorling Kinderesly, Page No-767-768
 Dutta DC. : Textbook Of Obstetrics”, Published by: New Central Book Agency,
Edition-6th Page no- 309-310
 https://www.healthline.com/health/uterine-fibroids
 https://www.medicalnewstoday.com/articles/151405.php
 https://www.uptodate.com/contents/uterine-fibroids-beyond-the-basics
 https://www.mountnittany.org/articles/healthsheets/2472