FIBROIDS PPT.pptx

Powerpoint presentation on uterine fibroids

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

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

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

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 leiomyoma s

16. SYMPTOMS OF FIBROIDS H eavy bleeding between or during your periods that includes blood clots P ain in the pelvis or lower back I ncreased menstrual cramping I ncreased urination P ain 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: L abour problems P regnancy problems Fertility problems R epeated 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: 12 th Page No: 1075-1078 Black M. Jouce ,” Medical-Surgical Nursing- Clinical Management For Positive Outcomes Volume 2”, Published by- W. B. Saunders Company, Edition 6 th , Page No- 991-994 Lemone Priscilla,” Medical Surgical Nursing-Critical Thinking In Client Care, Edition-4 th Published by- Dorling Kinderesly , Page No-767-768 Dutta DC. : Textbook Of Obstetrics”, Published by: New Central Book Agency, Edition-6 th 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