Uterine Fibromyoma and Intravascular Thrombosis—Eight CasesReport as inadecuate




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Objectives: We presenteight cases of vascular thrombosis of the pelvic vessels and deep venousthrombosis DVT of the lower limb, secondary to compression of the pelvicvessels by the uterine fibroid, managed over a span of twelve years from 2001to 2013. We discuss the mean size of the leiomyoma, the prediliction for DVT ofthe left lower limb, the role of oral contraceptives when used in women withlarge fibroids, to increase the risk of DVT and present a brief literaturereview. Results: Age, the mean age of our patients was—41.12yrs, range—18 yrs to 50 yrs. Parity and Menopausal Status: Seven wereparous women. One was unmarried, nulligravid. Seven were premenopausal andone was postmenopausal. Vascular Thrombosis: In one it was arterialthrombosis and in seven it was venous thrombosis. DVT was on the left sidein -6-8 - 75%. Clinical Complaints: The presentingcomplaints were heavy menstrual bleeding in three, severe dysmenorrhoeaand heavy bleeding in one, mass per abdomen in one, heavy menses andabdominal mass in one, no complaints apart from DVT in one. UterineEnlargement: The size of the uterus was between 12 to 26 weeks. The meansize was 20 weeks. It was a single fibromyoma in six and multiple, two intwo. Use of Oral Contraceptives: OC pills were used to control heavymenstrual bleeding in three cases—3-8, 37.5%. Discussion: The DVT wason the left side in six of our cases, 75% were on the left side in ourseries. Menstrual problems like heavy bleeding can be secondary to fibromyoma.Three of the eight—37.5%, women used OC pills to control menorrhagia. Onedeveloped DVT after one cycle of use of OC pills; the second developedarterial thrombosis of the pelvic vessels after four cycles of OC pill use; thethird used OC pills for a longer period, on and off. The woman who developedarterial thrombosis was using OC pills with 50 mcgs of oestrogen and 0.5 mgnorgestrel. Conclusions: Uterine leiomyoma can cause vascular thrombosissecondary to compression of the pelvic vessels. The mean size of the uterineenlargement by the fibromyoma was 20 weeks and in 6-8, it was a solitaryfibromyoma. DVT was on the left side in 75% of our cases. Use of OC pills inwomen with an enlarged uterus with leiomyoma can increase the risk of DVT.

KEYWORDS

Fibroid; Leiomyoma; DVT; Intravascular Thrombosis; IVL; Intravenous Leiomyomatosis; PTE

Cite this paper

Devabhaktuni, P. , Gupta, P. , Bhupatiraju, S. , Puranam, B. and Abdul, S. 2014 Uterine Fibromyoma and Intravascular Thrombosis—Eight Cases. Open Journal of Obstetrics and Gynecology, 4, 197-207. doi: 10.4236-ojog.2014.44033.





Author: Pratibha Devabhaktuni, Prem C. Gupta, Somaraju Bhupatiraju, Balamba Puranam, Saleem M. Abdul

Source: http://www.scirp.org/



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