Anatomical location of uterine fibroids among women attending a tertiary health facility in a southern Nigerian population

Joy E. Olotu; Michael Okon

doi:10.30574/gscbps.2021.14.2.0029

Authors

Joy E. Olotu Department of Anatomy, Faculty of Basic Medical Sciences, University of Port Harcourt, Rivers State, Nigeria.
Michael Okon Department of Anatomy, Faculty of Basic Medical Sciences, University of Port Harcourt, Rivers State, Nigeria.

DOI:

https://doi.org/10.30574/gscbps.2021.14.2.0029

Keywords:

Parity, Point Prevalence, Ultrasound, Uterine fibroids, Women Health

Abstract

Uterine fibroids are benign monoclonal tumours of the smooth muscle cells of the uterus and usually occur during reproductive age. Studies have revealed that it is more prone to women of African descent and the major factors responsible for this occurrence is yet to be accurately discovered. The study determined prevalence, sonographic location, and type of uterine fibroid among women undergoing ultrasound scan in Radiology Department of the University of Port Harcourt Teaching Hospital. The research was a retrospective study conducted from August to October 2019. Study population was 271 and included all consenting females within ages 18-55 years undergoing ultrasound scan at the study centre. Primary data was collected by direct interview using data collection sheet, parameters retrieved included age, marital status, parity and history of previous surgery, while secondary data collected from the Unit register and We extracted information about, presence, number and location of the fibroids from participant’ medical records. This was done for only women with confirmed cases of uterine fibroids. Analysis of data was done using SPSS version 22 and presented in diagrams, tables, figures and charts where appropriate. Point Prevalence was found to be 33.9%, respondents within ages 31 to 35 years (26.4%) presented with the highest prevalence of fibroid. Multiple fibroids with two or more nodules were found to be the most common from ultrasound scan (64.8%). In terms of types, intramural had the highest occurrence at 61.9%. Tumours are most frequently located in the anterior wall of the uterus (14.4%). Type and location of fibroid was seen to be mostly intramural and on the anterior wall of the uterus, respectively. This study found prevalence of uterine fibroid to be 33.9%, also nulliparous women were found to have the highest incidence of uterine fibroids. The point prevalence value for the study population is high, therefore, we suggest that awareness campaign be increased in the region.

Metrics

Metrics Loading ...

References

Zimmermann A, Bernuit D, Gerlinger C, Schaefer's M, Geppert K. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BioMed Central Women’s Health. 2012; 12: 6.

Okogbo FO, Ezechi OC, Loto OM, Ezeobi PM. Uterine leiomyomata in south western Nigeria a clinical study of presentations and management outcome. African Health Science. 2011; 11(2): 271-278.

Somigliana E, Vercellini P, Daguati R, Pasin R, Giorgi OG, Crosignani PG. Fibroids and female reproduction: a critical analysis of the evidence. Human Reproduction Update. 2007; 13(5): 465-476.

Breech LL, Rock JA. Leiomyomata uterus and myomectomy. (10th ed.). TeLinde’s operative gynaecology. 10th ed. Lippincott Williams and Wilkins, (Chapter 31). 2008.

Practice Committee, American Society for Reproductive Medicine. ACOG Education Bulletin. Myomas and Reproduction. Fertility and Sterility. 2008; 90(3): S125-S130.

Stewart EA, Nicholson W, Bradley L, Borah BJ. The Burden of uterine fibroids for African American women: Results of a national survey. Journal of Women’s Health. 2012; 22(10): 807-816.

Commandeur AE, Styler AK, Teixerirs JM. Epidemiological and genetic clues for molecular mechanisms involved in uterine leiomyoma development and growth. Human Reproduction Update. 2015; 21(5): 593 -615.

Olotu EJ, Osunwoke EA, Ugboma HA, Odu KN. Age prevalence of uterine of uterine fibroids in south-southern Nigeria: A retrospective study. Scientific Research and Essay. 2008; 3(9): 457-459.

Olotu EJ, Oladipo GS. Age Decline in the onset of Menarche in Southern Nigerian population. Global Journal of Medical Science. 2006; 5(2): 89-91.

Olufowobi O, Sharif K, Papaionnou S. Are the anticipated benefits of myomectormy achieved in women of reproductive age? A 5-year review of the results at a UK tertiary hospital. Journal of Obstetrics and Gynaecology. 2004; 24(4): 434 – 440.

Letterie G. Surgery, Assisted Reproductive Technology and Infertility. London: CRC Press. 2005.

Sidhu, Harpreet Rao, Kamini. Fibroids and Infertility. International Journal of Infertility & Foetal Medicine. 2014; 5: 1-7.

Ekwere PD, Archibong EI, Bassey EE, Ekabua JE, Ekanem EI, Feyi – Waboso P. Infertility among Nigerian Couples as seen in Calabar. Port Harcourt Medical Journal. 2007; 2: 35 – 40.

Harpreet K, Kamini AR. Fibroids and infertility. International Journal of Infertility and Foetal Medicine. 2014; 5(1): 1-7.

Okon M, Olotu EJ. Association between AGE, BMI, and the type and location of uterine leiomyoma: a UPTH study. European Journal of Biomedical and Pharmaceutical Sciences. 2020; 7(1): 103-107.

Lawal Y, Yaro IB, Rabiu A, Emmanuel R. Prevalence and Sonographic patterns of uterine fibroids in Northern Nigeria N. Nigerian Journal of Clinical Research. 2019; 8: 249.

Yu O, Scholes D, Schulze-Rath R, et al. A US population-based study of uterine fibroid diagnosis incidence, trends, and prevalence: 2005 through 2014. American Journal of Obstetrics and Gynaecology. 2018; 219(591): e1-e8.

Wise LA, Laughlin-Tommaso SK. Epidemiology of Uterine Fibroids: From Menarche to Menopause. Clinical Obstetrics and Gynecology. 2016; 59(1): 2–24.

Ernest A, Nwakalebela A, Mpondo BC. Uterine leiomyoma in a 19-year-old girl: Case report and literature review. Malawi Medical Journal. 2016; 28(1): 31-33.

Santoro N, Epperson CN, Mathews SB. Menopausal Symptoms and Their Management. Endocrinology Metabolism Clinics North America. 2015; 44(3): 497–515.

Templeman C, Marshall SF, Clarke CA, Henderson KD, Largent J, Neuhausen S. et al. Risk factors for surgically removed fibroids in a large cohort of teachers. Fertility Sterility. 2009; 92(4): 1436–1446.

Ghosh S, Naftalin J, Imrie R, Hoo W-L. Natural History of Uterine Fibroids: A Radiological Perspective. Current Obstetrics and Gynaecology Reports. 2018; 7(3): 117–121.

Mavrelos D, Ben-Nagi J, Holland T, Hoo W, Naftalin J, Jurkovic D. The natural history of fibroids. Ultrasound Obstetrics and Gynaecology. 2010; 35(2): 238–242.

Peddada SD, Laughlin SK, Miner K, Guyon JP, Haneke K, Vahdat HL et al. Growth of uterine leiomyomata among premenopausal black and white women. Proceedings of the National Academy Sciences of the United State American, 2008; 105(50): 19887–19892.

Baird DD, Dunnson DB, Hill MC, Cousin D, Schectma JM. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. American Journal of Obstetrics and Gynaecology. 2003; 188: 100-107.

Wise LA, Palmer JR, Harlow BL et al. Reproductive factors, hormonal contraception, and risk of uterine leiomyomata in African American women: a prospective study. American Journal of Epidemiology. 2004; 159(2): 113–123.

Parazzini F. Risk factors for clinically diagnosed uterine fibroids in women around menopause. Maturitas. 2006; 55(2): 174–179.

Klatsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. American Journal of Obstetrics Gynaecology. 2008; 198: 357-366.

Muram D, Gillieson M, Walters JH. Myomas of the uterus in pregnancy: ultrasonographic follow-up. American Journal of Obstetrics and Gynaecology. 1980; 138: 16-19.

Rice JP, Kay HH, Mahony BS. The clinical significance of uterine leiomyomas in pregnancy. American Journal of Obstetrics and Gynaecology. 1989; 160: 1212-1216.

Saravelos SH, Yan J, Rehmani H, Li TC. The prevalence and impact of fibroids and their treatment on the outcome of pregnancy in women with recurrent miscarriage. Human Reproduction. 2011; 26(12): 3274-3279.

Casini M, Rossi F, Agostini R, Unfer V. Effect of the position of fibroids on fertility. Gynaecological Endocrinology. 2006; 22: 106-109.

Richards PA, Richards PDG, Tiltman AJ. The ultrastructure of fibromyomatous myometrium and its relationship to infertility. Human Reproduction Update. 1998; 4: 520–525.

Dessolle L, Soriano D, Poncelet C. Determinants of pregnancy rate and obstetric outcome after laparoscopic myomectomy for fertility. Fertility Sterility. 2001; 76: 370–374.

Levens ED, Wesley R, Premkumar A, Blocker W, Nieman LK. Magnetic resonance imaging and transvaginal ultrasound for determining fibroid burden: implications for research and clinical care. American Journal of Obstetrics and Gynaecology. 2009; 200(5): 537.

Wilde S, Scott-Barrett S. Radiological appearances of uterine fibroids. Indian Journal of Radiologic Imaging. 2009; 19(3): 222–231.

Dueholm M, Lundorf E, Hansen ES, Ledertoug S, Olesen F. Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas. American Journal of Obstetrics and Gynaecology. 2002; 186: 409–415.

Cicinelli E, Romano F, Anastasio PS, Blasi N, Parisi C, Galantino P. Transabdominal sonohysterography, transvaginal sonography, and hysteroscopy in the evaluation of submucous myomas. Obstetrics and Gynaecology. 1995; 85: 42-47.

Becker EJr, Lev-Toaff AS, Kaufman EP, Halpern EJ, Edelweiss MI, Kurtz AB. The added value of transvaginal sonohysterography over transvaginal sonography alone in women with known or suspected leiomyoma. Journal Ultrasound Medicine. 2002; 21: 237-247.