Rossdonaldson1: /* See Also */

2025-02-26T22:31:35Z

Rossdonaldson1: /* Differential Diagnosis */

2025-02-26T22:24:30Z

Differential Diagnosis

← Older revision		Revision as of 22:24, 26 February 2025
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Pregnancy]]
	*[[Ectopic pregnancy]]

	{{VB DDX nonpregnant}}		{{VB DDX nonpregnant}}
	{{PALM-COEIN Classification}}		{{PALM-COEIN Classification}}

Rossdonaldson1: /* Differential Diagnosis */

2025-02-26T22:24:04Z

Differential Diagnosis

← Older revision		Revision as of 22:24, 26 February 2025
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	*[[Pregnancy]]		*[[Pregnancy]]
	*[[Ectopic pregnancy]]		*[[Ectopic pregnancy]]

			{{VB DDX nonpregnant}}
	{{PALM-COEIN Classification}}		{{PALM-COEIN Classification}}

Rossdonaldson1 at 16:05, 14 February 2024

2024-02-14T16:05:13Z

← Older revision		Revision as of 16:05, 14 February 2024
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	*Consider leiomyosarcomas in postmenopausal women, as they can present similarly		*Consider leiomyosarcomas in postmenopausal women, as they can present similarly

	==Risk Factors==		===Risk Factors===
	*Any condition that increases cumulative estrogen exposure		*Any condition that increases cumulative estrogen exposure
	**Early menarche		**Early menarche
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	==References==		==References==
	<references/>		<references/>

			[[Category:OBGYN]]

Patricklin: Created page with "==Background== *Leiomyomas, also called fibroids, are the most common benign tumor in women By age 50, incidence of up to 70% of white women and 80% of black womenBaird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003 Jan;188(1):100-7. doi: 10.1067/mob.2003.99. PMID: 12548202. Arises most commonly in women of reproductive age, with decrea..."

2023-12-05T09:59:48Z

Created page with "==Background== *Leiomyomas, also called fibroids, are the most common benign tumor in women **By age 50, incidence of up to 70% of white women and 80% of black women<ref>Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003 Jan;188(1):100-7. doi: 10.1067/mob.2003.99. PMID: 12548202.</ref> **Arises most commonly in women of reproductive age, with decrea..."

New page

==Background==
*Leiomyomas, also called fibroids, are the most common benign tumor in women
**By age 50, incidence of up to 70% of white women and 80% of black women<ref>Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003 Jan;188(1):100-7. doi: 10.1067/mob.2003.99. PMID: 12548202.</ref>
**Arises most commonly in women of reproductive age, with decreasing rates in postmenopausal women
*Fibroids may be located in different layers of the uterus: subserosal, intramural, or submucosal
*Pathogenesis: Primarily an estrogen-dependent myometrial proliferation, with varying fibrous connective tissue
*Consider leiomyosarcomas in postmenopausal women, as they can present similarly

==Risk Factors==
*Any condition that increases cumulative estrogen exposure
**Early menarche
**Nulliparity
**Estrogen-containing OCP use
**Obesity

==Clinical Features==
*[[Vaginal bleeding]]
*[[Pelvic pain]], including dyspareunia
*Urinary incontinence/retention
*Constipation/diarrhea
*Symptomatic [[anemia]]
*Infertility
Alternatively, may be asymptomatic and show as incidental finding on imaging

==Differential Diagnosis==
*[[Pregnancy]]
*[[Ectopic pregnancy]]
{{PALM-COEIN Classification}}

==Evaluation==
*Evaluate with speculum and bimanual exam

===Workup===
*bHCG/urine pregnancy
*CBC
*Transvaginal ultrasound is the preferred modality for diagnosis
**Shows as well-circumscribed, hypoechoic masses with varying calcification and shadowing
*CT has less utility compared to pelvic ultrasound, but MRI may be performed for surgical planning in specific cases

==Management==
*[[NSAID]]
*Fluids and blood products, if indicated
*Hormonal agents such as OCPs or GnRH agonists may be initiated with consultation with OB/GYN
*Expectant management, if asymptomatic

==Disposition==
*Depends on severity of symptoms and hemodynamic stability
*Refer to OB/GYN for further medical management such as hormonal agents<ref>Management of Symptomatic Uterine Leiomyomas: ACOG Practice Bulletin, Number 228. Obstetrics & Gynecology 137(6):p e100-e115, June 2021. | DOI: 10.1097/AOG.0000000000004401</ref>
**Also for surgical management including myomectomy vs hysterectomy vs IR-guided uterine artery embolization<ref>De La Cruz MS, Buchanan EM. Uterine Fibroids: Diagnosis and Treatment. Am Fam Physician. 2017 Jan 15;95(2):100-107. PMID: 28084714.</ref>

==See Also==

==External Links==

==References==
<references/>

← Older revision		Revision as of 22:31, 26 February 2025
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	==See Also==		==See Also==
			*[[Nonpregnant vaginal bleeding]]

	==External Links==		==External Links==

Leiomyoma - Revision history

Rossdonaldson1: /* See Also */

Rossdonaldson1: /* Differential Diagnosis */

Rossdonaldson1: /* Differential Diagnosis */

Rossdonaldson1 at 16:05, 14 February 2024