Summary of "Uterine fibroid - causes, symptoms, diagnosis, treatment, pathology"

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Understanding Uterine fibroids
- Uterine fibroids (leiomyomas) are benign smooth muscle tumors of the uterus.
- Most common tumors in females, especially affecting women of African descent.
- Hormones like estrogen and progesterone promote fibroid growth by upregulating growth factors.
- Fibroids typically develop in pre-menopausal women and grow rapidly during pregnancy due to high hormone levels.
- Risk factors include never having been pregnant, frequent menstrual cycles, and historical exposure to estrogen-like medications.
Types and Locations of Fibroids
- Intramural fibroids: Within the uterine wall (most common).
- Subserosal fibroids: On the outer surface of the uterus; can detach and get blood supply from nearby organs.
- Submucosal fibroids: Just beneath the uterine lining; can distort the uterine cavity and become pedunculated.
- Cervical fibroids: Located in the cervix wall.
Symptoms and Impact
- Many fibroids are asymptomatic.
- Symptoms include heavy or prolonged menstrual bleeding, abdominal pain, and pressure on pelvic organs.
- Can cause iron deficiency anemia due to bleeding.
- Submucosal and Intramural fibroids may cause infertility and increase miscarriage risk.
- During pregnancy, fibroids can cause fetal malpresentation, preterm labor, and postpartum hemorrhage.
Diagnosis
- Pelvic exam and ultrasound are primary diagnostic tools.
- Biopsy is rarely done but can rule out uterine sarcoma; fibroids show a characteristic whorled pattern of smooth muscle bundles.
Treatment Options
- Asymptomatic fibroids: Usually no treatment needed.
- Symptomatic fibroids:
  - Surgical options:
    - Myomectomy (removal of fibroids, preserving the uterus).
    - Hysterectomy (removal of the uterus, for women not desiring future pregnancies).
  - Non-invasive:
    - Uterine artery embolization to reduce blood flow and shrink fibroids.
  - Medications:
    - Gonadotropin-releasing hormone analogues to shrink fibroids before surgery.