PATHOPHYSIOLOGY Predisposing Factors: -Advancing Age (>30 yrs old) -Gender (Female) -Early menstruation
Increased exposure to estrogen
Idiopathic
Preitating Factors: -Multiparity (More than 3-5 pregnancies) -Stress
Activation of SNS Potential injury to the endometrial and myometrial layer of the uterus.
Proliferation of cells in the uterus
Overgrowth of the endometrial lining
Development of fibroid tissues to different sites within the uterus
Secretion of Norepinephrine
Repeated exposure to stress
Hyperstimulation of SNS
Increased uterine contractility
Disruption of estrogen production
Abrupt withdrawal causes an increased estrogen production
Myoma uteri
Subserous
Intramural
Submucous
Growth outside folds of broad ligament
Develops inside the organ
Growth on the endometrium
Obstruction in the omentum
Increased growth in the site give rise to obstruction within the organ thus impeding blood flow and increasing congestion within the site.
Ligament becomes thinner
Menorrhagia
Obstruction on the blood vessels of the endometrium Pain
Deterioration at the part of the fibroid and endometrial lining
Sloughing off of endometrial layers
Dysmenorrhea
Hypotension Dizziness
Severe Bleeding Decreased Hemoglobin Decreased Hematocrit Fatigue Activity Intolerance Difficulty of Breathing Confusion
Anemia
If treated: - Iron Supplements -
Blood Transfusion
-
Antibiotics
-
Radiation therapy (in rare cases)
If not treated
Severe bleeding
Increase in tumor size Obstructs other organs
Good Prognosis Hypovolemic Shock
Decreased blood supply Tissue hypoxia
Necrosis
Death
Organ malfunction