Can i be pregnant with submucosal fibroid,when can a woman get pregnant easily 2014,conception yoga poses,first trimester pregnancy ultrasound pictures - PDF 2016

The Female Reproductive SystemThe primary structures in the reproductive system include: The uterus is a pear-shaped organ located between the bladder and lower intestine. Uterine (Endometrial) CancerAny fibroid has the rare potential to be cancerous (malignant). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. It consists of two parts, the body and the cervix. When a woman is not pregnant the body of the uterus is about the size of a fist, with its walls pressed against each other. This condition occurs when glands from the uterine lining become embedded in the uterine muscle. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.
During pregnancy the walls of the uterus are pushed apart as the fetus grows. The cervix is the lower portion of the uterus. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.
It has a canal opening into the vagina with an opening called the os, which allows menstrual blood to flow out of the uterus into the vagina. Leading off each side of the body of the uterus are two tubes known as the fallopian tubes. Women with symptoms from their fibroids have many options for treatment, including drugs and surgery. Near the end of each tube is an ovary. Ovaries are egg-producing organs that hold 200,000 - 400,000 follicles (from folliculus, meaning "sack" in Latin). The power morcellator is a medical device used to cut up fibroids or the uterus into tiny fragments for easier removal.
There is evidence that this procedure may spread cancer in women who have undetected uterine cancer. IntroductionA uterine fibroid (known medically as a leiomyoma or myoma) is a noncancerous (benign) growth of smooth muscle and connective tissue. During pregnancy this inner lining thickens and becomes enriched with blood vessels to house and support the growing fetus. They include removal of the fibroid (myomectomy), removal of the endometrial lining (endometrial ablation), shrinking the blood supply to the fibroid (uterine artery embolization), and removal of the uterus (hysterectomy).
Very large fibroids may give the abdomen the appearance of pregnancy and cause a feeling of heaviness and pressure.
Deciding on a particular surgical procedure depends on the location, size, and number of fibroids. Subserosal can be either stalk-like (pedunculated) or broad-based (sessile). Submucosal fibroids grow from the uterine wall toward and into the inner lining of the uterus (the endometrium). Certain procedures affect a woman's fertility and are recommended only for women who are past childbearing age or who do not want to become pregnant. It is not clear what causes fibroids, but estrogen and progesterone appear to play a major role in their growth. DiagnosisPelvic Exam and Medical HistoryDoctors can detect some fibroids as masses (lumps) during a pelvic exam.
During a pelvic exam, the doctor will check for pregnancy-related conditions and other conditions, such as ovarian cysts. Newer types of continuous-dosing OCs reduce or eliminate the number of periods a woman has per year. Intrauterine devices (IUDs) that release progestin can help reduce heavy bleeding. The doctor will ask you about your medical history, particularly as it relates to menstrual bleeding patterns. Specifically, the levonorgestrel-releasing intrauterine system, or LNG-IUS (Mirena), has shown excellent results. Other causes of abnormal uterine bleeding must also be considered. UltrasoundUltrasound is the standard imaging technique for detecting uterine fibroids. Female infertility is usually due to other factors than fibroids. Effect on PregnancyFibroids may increase pregnancy complications and delivery risks.
GnRH agonists block the release of the reproductive hormones LH (luteinizing hormone) and FSH (follicle-stimulating hormone).
Small, submucosal fibroids are most likely to cause abnormally heavy bleeding. Most cases of anemia are mild and can be treated with dietary changes and iron supplements. It may also be used during surgical procedures to remove fibroids. Hysteroscopy can be performed in a doctor's office or in a hospital setting.
The procedure uses a long flexible tube called a hysteroscope, which is inserted into the vagina and through the cervix to reach the uterus. They may also be used as a preoperative treatment 3 to 4 months before fibroid surgery to reduce fibroid size so that a more minimally invasive surgical procedure can be performed.
A fiber-optic light source and a tiny camera in the tube allow the doctor to view the cavity. The uterus is filled with saline or carbon dioxide to inflate the cavity and provide better viewing.
Local, regional, or general anesthesia is typically given. LaparoscopyIn some cases, laparoscopic surgery may be performed as a diagnostic procedure.
Women should not take these drugs for more than 6 months. GnRH treatments used alone do not prevent pregnancy.


Laparoscopy involves inserting a fiber-optic scope into a small incision made near the navel.
Whereas hysteroscopy allows the doctor to view inside the uterus, laparoscopy provides a view of the outside of the uterus, including the ovaries, fallopian tubes, and general pelvic area. Other TestsIn certain cases, the doctor may perform an endometrial biopsy to determine if there are abnormal cells in the lining of the uterus that suggest cancer. If the fibroids are numerous or large, myomectomy can become complicated, resulting in increased blood loss. It can be used to take tissue samples and also as a procedure to help temporarily reduce heavy menstrual bleeding. It is used for subserosal or intramural fibroids that are very large (usually more than 4 inches), that are numerous, or when cancer is suspected. While complete recovery takes less than a week with laparoscopy and hysteroscopy, recovery from a standard abdominal myomectomy takes as long as 6 to 8 weeks. With this procedure, fibroids are removed using an instrument called a hysteroscopic resectoscope, which is passed up into the uterine cavity through the vagina and cervical canal.
Laparoscopy requires only tiny incisions, and has a much faster recovery time than laparotomy. There is evidence that power morcellation may spread cancerous tissue in women with fibroids who have undetected uterine cancer.
The FDA advises against the use of laparoscopic power morcellators for myomectomy or hysterectomy procedures. They can recur after these procedures. Uterine Artery EmbolizationUterine artery embolization (UAE), also called uterine fibroid embolization (UFE), is a relatively new way of treating fibroids.
It is less invasive than hysterectomy and myomectomy, and involves a shorter recovery time than the other procedures. The femoral artery is a large artery that begins in the lower abdomen and extends down to the thigh.
The radiologist then threads the catheter into the uterine artery. Small plastic particles are injected into the artery. These particles block the blood supply to the tiny arteries that feed fibroid cells, and the tissue eventually dies. Patients usually stay in the hospital overnight after UAE and are given pain medication. Pelvic cramps are common for the first 24 hours after the procedure. It takes 1 to 2 weeks for the patient to recover from the procedure and return to work.
It may take several months to several years for the fibroids to completely shrink. Most patients have a light, brownish color vaginal discharge for several days following UAE, which may last until the next menstrual cycle.
Effect on Fertility: In general, UAE is considered an option for only those who have completed childbearing.
The American College of Obstetricians and Gynecologists advises women who wish to have children that it is not yet known how this procedure affects their potential for becoming pregnant. In addition to potential impact on fertility, other postoperative effects may include. Pain. Abdominal cramps and pelvic pain after the procedure are nearly universal and may be intense. A low-grade fever and general malaise are also common in the first week after the procedure. Early menopause.
Success Rates: Uterine artery embolization is very effective and most women are very satisfied with the results. Menorrhagia symptoms, as well as pelvic pain and urinary symptoms, improve in 85 to 95% of women within 3 months after treatment.
In the rare cases of sarcoma (cancer cells in the muscles of the uterus), this procedure may delay diagnosis and therefore worsen prognosis.
It is not helpful for large fibroids or for fibroids that have grown outside of the interior uterine lining.
In some women, menstrual flow is not stopped but is significantly reduced. Most endometrial ablation procedures use some form of heat (radiofrequency, heated fluid, microwave) to destroy the uterine lining. The procedure is typically done on an outpatient basis and can take as few as 10 minutes to perform. Recovery generally takes a few days, although watery or bloody discharge can last for several weeks. Endometrial ablation significantly decreases the likelihood a woman will become pregnant.
However, pregnancy can still occur and this procedure increases the risks of complications, including miscarriage.
Women who have this procedure must be committed to not becoming pregnant and to using birth control.
This “thermal ablation” procedure is performed with a device, the ExAblate, which combines magnetic resonance imaging (MRI) with ultrasound. During the 3-hour procedure, the patient lies inside an MRI machine. The patient receives a mild sedative to help relax but remains conscious throughout the procedure. The MRI also helps the radiologist monitor the temperature generated by the ultrasound. MRgFUS is appropriate only for women who have completed childbearing or who do not intend to become pregnant. Fibroids that are located near the bowel and bladder, or outside of the imaging area, cannot be treated. This procedure is relatively new, and long-term results are not yet available. Many insurance companies consider this procedure investigational, experimental, and unproven and do not pay for this treatment. HysterectomyHysterectomy is the surgical removal of the uterus. Hysterectomy is a permanent solution for fibroids, and is an option if other treatments have not worked or are not appropriate. A woman cannot become pregnant after having a hysterectomy.


If the ovaries are removed along with the uterus, hysterectomy causes immediate menopause. Types of HysterectomiesOnce a decision for a hysterectomy has been made, the patient should discuss with her doctor what will be removed.
It is an invasive procedure that is is best suited for women with large fibroids, when the ovaries also need to be removed, or when cancer or pelvic disease is present. The cut may either be vertical, or it may go horizontally across the abdomen, just above the pubic hair (a bikini cut). The bikini cut incision heals faster and is less noticeable than a vertical incision, which is used in more complicated cases.
The American College of Obstetricians and Gynecologists (ACOG) recommends vaginal hysterectomy as the first choice, when possible. The vaginal incision is closed with stitches. ACOG recommends laparoscopic hysterectomy as the second choice for minimally invasive procedures. The laparoscope is a thin flexible tube through which a tiny video camera and surgical instruments are inserted.
It uses several small abdominal incisions through which the surgeon severs the attachments to the uterus and, if needed, ovaries. In LAVH, the uterus (and ovaries) is then removed through the vaginal incision, as in the standard vaginal approach.
Before choosing robotic hysterectomy, it is important to find a surgeon who has extensive training and experience with this technique. The power morcellator is a cutting device that breaks up the uterus into smaller fragments that can be removed through small abdominal incisions. About 1 in 350 women who undergo hysterectomy or myomectomy for uterine fibroids have this type of cancer. Younger women who are considering a fibroid procedure using power morcellation should discuss with their doctors all possible risks. Postoperative CareAsk a family member or friend to help out for the first few days at home. Women who have had abdominal hysterectomies should discuss with their doctors when exercise programs more intense than walking can be started. The abdominal muscles are important for supporting the upper body, and recovering strength may take a long time.
Even after the wound has healed, the patient may have an on-going feeling of overall weakness, for some time.
Some women do not feel completely well for as long as a year while others may recover in only a few weeks. If a woman has had her cervix removed, she no longer needs annual Pap smears. However, women who have had any type of hysterectomy should continue to receive routine pelvic and breast exams, and mammograms. Premature Menopause after HysterectomySurgical removal of the ovaries causes immediate menopause. If the ovaries are not removed, they will usually continue to secrete hormones until the natural age of menopause (average age 51 years), even after the uterus is removed. Studies show that women who have had hysterectomies become menopausal on average 1 to 3 years earlier than would naturally occur. Your doctor may recommend you take hormone therapy (HT) after your hysterectomy. Women who have had a hysterectomy are given estrogen-only therapy (ET), which may be administered as pills or as a skin patch that releases the hormone into the bloodstream. It can also be given “locally” to treat specific symptoms such as vaginal dryness (see below).
Hot flashes are often more severe after surgical menopause than in menopause that occurs naturally. Sexuality after HysterectomySexual intercourse may resume 6 to 12 weeks following surgery. Other women report increased sexual drive and pleasure because they are free from the problems that prompted hysterectomy. A vaginal lubricant can help reduce vaginal dryness. Your doctor can also prescribe a low-dose vaginal estrogen treatment, which is applied directly the vagina. Topical vaginal estrogen is available in a cream, tablet, or ring that is inserted into the vagina. Medical Eligibility Criteria for Contraceptive Use, 2010: adapted from the World Health Organization Medical Eligibility Criteria for Contraceptive Use, 4th edition.
Uterine artery embolization for fibroids is associated with an increased risk of miscarriage.
Levonorgestrel-releasing intrauterine system and endometrial ablation in heavy menstrual bleeding: a systematic review and meta-analysis. Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results.
Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses' health study. Leiomyomas at routine second-trimester ultrasound examination and adverse obstetric outcomes.
Uterine artery embolization versus surgery in the treatment of symptomatic fibroids: a systematic review and metaanalysis. Robotically assisted vs laparoscopic hysterectomy among women with benign gynecologic disease.



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