THE PREVALENCE OF UTERINE MYOMA AS DIAGNOSE WITH ULTRASOUND AMONGST WOMEN OF CHILD BEARING AGE AT PADRE POI HOSPITAL DOUALA

Abstract

Uterine Myoma commonly called fibroids are benign neoplasm of uterine smooth muscle. Uterine myoma are the most common pelvic tumors in women occurring globally with the prevalence of 21.4% ( sumyvalue. 2016). Myoma has been one of the major health problems for several years and major cause of worries to women, couple, families and community.

The infertility cause by this fibroid has rendered many blissful marriages to end up in disharmony and divorce. The purpose of this study was to assess the prevalence of uterine myoma among women of child bearing age.

This was a hospital base retrospective study carried out in St PadrePoi hospital Douala from November 2020 to January 2021. Out of 6620 women of child bearing age who come for pelvic ultrasound at St Padre poi hospital 316 were selected by a convenient sampling method.

The study showed that the prevalence of uterine myoma was 4.7%. Sub serosal stands to be the highest with a prevalence of 1.9(126) and pendiculated the lowest 0.4 (31). Infertility was the most common clinical findings with 176(55.5%) and 7.6(24.1%) had pelvic mass.

Therefore uterine fibroids are common concern to women in fertile age and their impact on women’s health are still limited and further research is required.

CHARPTER ONE

INTRODUCTION

1.1 Background of the Study

Uterine myoma commonly called ‘fibroids’ are benign neoplasm of uterine smooth muscle. Despite the fact that their cause is still unknown yet there is considerable evidence that estrogen and progesterone increase the rate of tumors growth (Ukwenyaetal., 2015).

Although they are often asymptomatic, myoma can cause excessive menstrual bleeding, pelvic pains, infertility, increase urinary frequency, fatigue and other symptoms that seriously affect a woman’s quality of life. Pelvic ultrasound has been considered one of the imaging modalities use in the diagnosis uterine myoma.

Uterine myomas are the most common pelvic tumors in women occurring globally with the prevalence of 21.4% (Sunnyvale, 2016). Usually uterine myomas are found during a routine gynecologic visit with a pelvic examination. A pelvic scan allow the sonographer to know the size, type and number of myoma in the uterus.

Also to know if the uterus has been enlarged or irregular. Uterine myomas are often associated with other gynecologic disease such as endometriosis which can be identified incidentally during this examination (Lauren et al., 2013). Foreign research indicated that the prevalence of uterine myoma was more than 25% in women of child bearing age in developed countries.

At present the etiology and pathogenesis of uterine myoma are still not very clear. The risk factors for developing uterine myoma include age, number of births, obesity, smoking, blood pressure, diet, stress and environment. It has been observed that long-term use of oral contraceptives increase the risk of uterine myoma in women of child bearing age.

The incidence of uterine myoma depends on age and race. It is quite high in black women of over 25 years of age than in white women (Adegbesan et al., 2014). Childbearing age as define by W.H.O childbearing age can be defined as a period in which women can get pregnant and bear children from puberty when they start their menstrual period to menopause when they stop getting it (15-49years).

Uterine myoma are often described based on their location within the uterus; this description of locations include; subserous, submucosal, intramural, cervical, exophytic. Sonographically uterine myoma appears as a well circumscribed, hypoechoic mass with increased attenuation within the mass.

Fibroids show a classical vascular supply with circumferential vessels, which are easily, demonstrated using Doppler. From 2017 to 2019, inpatient admission for uterine myoma at St Padre Poi Hospital Douala increase by 20% and uterine myoma remain the most common diagnosis among inpatient hospitalization for gynecological conditions in women 25-44years of age. (St Padre poi hospital record books).

However, a rate of alternative surgeries, such as myomectomy has increased during this same period. Despite their substantial impact on gynecologic morbidity, relatively little is known about the prevalence of uterine myomaat St Padre Poi Hospital Douala. Hence we aim at investigating the prevalence of uterine myoma among women of child bearing attending St Padre Poi Hospital Douala.

1.2. Problem Statement

Uterine myoma commonly called ‘fibroids’ have been one of the major health problems for several years and major cause of worries to women, couples, families and community. The infertility caused by this fibroid has rendered many blissful marriages to end up in disharmony and divorce. Studies have shown that uterine myoma is very common among women of child bearing age than any other age group (Danboyi et al.,2012). Hence we aimed at investigating the prevalence of uterine myoma among women of child bearing age attending St Padre Poi Hospital Douala.

1.3 Research Hypothesis

There was a high prevalence of uterine myoma among women of childbearing age attending St Padre Poi Hospital Douala.

1.4 Research Objective

I.4.1 General Objective

To assess the prevalence of uterine myoma among women of child bearing age attending St Padre Poi Hospital Douala.

1.4.2 Specific objective

1. To determine the different types of uterine myoma among women of child bearing age attending St Padre Poi Hospital Douala.
2. To find out which type of uterine myoma is the most common among women of child bearing age.
3. To determine clinical indications most likely associated with uterine myoma.
4. To determine the prevalence of uterine myoma

1.5 Research Question

1. What were the different types of uterine myoma diagnosed with ultrasound among women of child bearing age?
2. Which type of uterine myoma was the most common among women of child bearing age?
3. What were the clinical indications most likely associated with uterine myoma?
4. What was the prevalence of uterine myoma among women of child bearing age?