Myoma, Cord prolapse & Uterine Atony

Question 1

benign tumor that forms in the muscle tissue of the uterus also known as fibroids

Answer 1

Myoma

Question 2

myomas are made of

Answer 2

smooth muscle and fibrous tissue

Question 3

2 distinct components contribute to leiomyoma development

Answer 3

Initiating event
Growth phase

Question 4

transformation of normal myocytes into abnormal myocytes

Answer 4

initiating event

Question 5

growth of abnormal myocytes into clinically apparent tumor

Answer 5

growth phase

Question 6

3 types of myocytes

Answer 6

skeletal myocytes
cardiac myocytes
smooth myocytes

Question 7

On the outer wall of the uterus, causing pressure on surrounding organs.

Answer 7

Subserosal

Question 8

Inside the muscular wall of the uterus, which is the most common type.

Answer 8

Intramural

Question 9

Beneath the lining of the uterus (endometrium), which can affect menstruation and cause heavy bleeding.

Answer 9

Submucosal

Question 10

Located in the cervix neck of the uterus (less common)

Answer 10

Cervical

Question 11

risk factors of myoma

Answer 11

•Age
• Hormones
• Diet
•Physical activity
• Race and genetics
• Endocrine disruptors
• lifestyle

Question 12

clinical findings of myoma

Answer 12

• Palpable abdominal mass
•Heavy or Prolonged Menstrual Bleeding (Menorrhagia)
• Irregularly enlarge and asymmetrical in pelvic examination
• Tender and large sizes unlike soft uterus containing a pregnancy
• Sign of anemia due to menorrhagia

Question 13

differential diagnosis of myoma

Answer 13

•Adenomyosis
•Endometriosis
•Pregnancy
• Leiomyosarcoma
•Edometrial carcinoma
•Uterine caecinosarcoma

Question 14

Is when tissue similar to the lining of your uterus (endometrium) starts to grow into the muscle wall of your uterus (myometrium). It causes your uterus to thicken and enlarge — sometimes, up to double or triple its usual size.

Answer 14

Adenomyosis

Question 15

Ademyosis can cause

Answer 15

painful periods
heavy or prolonged menstrual bleeding
abdominal/pelvic pain

Question 16

• is a state of having implanted products of conception located either in the uterus or elsewhere in the body. It ends through either spontaneous or elective abortion or delivery.
During this time, the mother’s body goes through immense changes involving all organ systems to sustain the growing fetus.

Answer 16

pregnancy

Question 17

an uncommon smooth muscle tumour and they account for just 1.3% of all uterine malignancies

Answer 17

leiomyosarcoma

Question 18

leiomyosarcoma presentation

Answer 18

abnormal uterine bleeding
abdominal pain
pelvic mass

Question 19

is rarely detected during pregnancy or within a year postpartum because the tumor can disrupt the pregnancy.

Answer 19

endometrial carcinoma

Question 20

rare and aggressive type of uterine cancer that contains both carcinoma (cancer of epithelial cells, which line the surface of organs) and sarcoma (cancer of the connective tissue). It starts from cells in the endometrium on the inside surface of the uterus

Answer 20

Carcinosarcinoma

Question 21

cancer of epithelial cells, which line the surface of organs

Answer 21

carcinoma

Question 22

cancer of the connective tissue

Answer 22

sarcoma

Question 23

investigation

Answer 23

pregnancy test
full blood count
pelvic ultrasound
mri
endometrial sampling
hysteroscopy with biopsies

Question 24

projects to the outside of uterus

Answer 24

subserosal fibroids

Question 25

subserosal fibroids s&s

Answer 25

pain urinating frequent urination infection

Question 26

bulge in uterine cavity

Answer 26

submucosal fibroids

Question 27

submucosal fibroids s&s

Answer 27

hypermenorrhea bleeding between periods cramps fetal deformities infertility

Question 28

grown within the muscular wall

Answer 28

intramural fibroids

Question 29

pedunculated submucosal (inside)

Answer 29

persistent inter menstrual bleeding

Question 30

pedunculated subserosal (outside)

Answer 30

dyspareunia

Question 31

Removal of the fibroids while preserving the uterus, often recommended for women who wish to maintain fertility.

Answer 31

myomectomy

Question 32

Removal of the entire uterus, considered when fibroids are large or causing severe symptoms, or if a woman has completed her family planning.

Answer 32

hysterectomy

Question 33

•Surgical procedure using laparoscope to remove the uterus and or fallopian tubes and ovaries through the vagina

Answer 33

LAVH laparoscopic assisted vaginal hysterectomy

Question 34

•Is both effective and relatively safe for women who no longer wish to have children • Ensuring the tumor is a benign

Answer 34

uterine artery embolization

Question 35

complication in pregnancy ( myoma)

Answer 35

• Recurrent miscarriage •Fetal malpresentation •Intrauterine growth retardation •Premature labor •Postpartum haemorrhage

Question 36

risk factors of cord prolapse

Answer 36

atypical presentation multiple babies preterm labor low birth weight polyhydramnios premature rupture of membranes multiparity velamentous cord insertion

Question 37

• Cord is adjacent to the presenting part. • Cannot be palpated during pelvic examination. • The umbilical cord descends alongside the presenting fetal part but remains undetectable upon vaginal examination. • Cord compression may still occur, leading to fetal distress.

Answer 37

occult (hidden) cord prolapse

Question 38

The umbilical cord is positioned between the fetal presenting part and the cervix but has not yet prolapsed beyond the cervix. • It is detected through ultrasound or vaginal examination before membrane rupture. • This condition increases the risk of overt prolapse when the membranes rupture.

Answer 38

funic cord prolapse

Question 39

The umbilical cord slips past the presenting part and is visible at the vaginal opening or can be felt during a vaginal examination. • Umbilical cord lies below the presenting part. • This is an obstetric emergency requiring immediate intervention to prevent fetal hypoxia.

Answer 39

overt cord prolapse

Question 40

factors of cord prolapse

Answer 40

spontaneous & iatrogenic

Question 41

spontaneous fetal factors

Answer 41

• Prematurity and IUGR • Abnormal Lies • Malpresentation • Fetal anomaly • Multiple Pregnancy/Multifetal • Gestation

Question 42

SPONTANEOUS: MATERNAL FACTORS

Answer 42

•Rupture of Membranes • Amniotomy (AROM) • Maternal Age (35 above)

Question 43

SPONTANEOUS: PLACENTAL FACTORS

Answer 43

placenta previa polyhydramnios

Question 44

iatrogenic procedure related

Answer 44

• Amniotomy • Amnion infusion • Placement of a cervical ripening balloon catheter

Question 45

diagnostic test for cord prolapse

Answer 45

vaginal examination obstetric abdominal examination cardiotocography

Question 46

position of cord prolapse

Answer 46

knee chest sim's trendelendburg

Question 47

is a serious condition that can occur after childbirth. It occurs when the uterus fails to contract after the delivery of the baby, and it can lead to a potentially life-threatening condition known as postpartum hemorrhage.

Answer 47

uterine atony

Question 48

risk factors of uterine atony

Answer 48

1. uterine overdistention 2. Anesthesia 3.Exhausted myometrium 4.ineffective uterine contraction

Question 49

symptoms of of uterine atony

Answer 49

1.heavy, prolonged and sudden bleeding after delivery 2.soft, boggy uterus 3.rapid pulse 4. low bp 5.dizziness or fainting

Question 50

management for uterine atony

Answer 50

1.positioning 2. Massage 3. Drug 4. Bakri Balloon tamponade