Uzi fibroids on different days of the cycle. When is it better to do an ultrasound of the uterus with uterine fibroids

Myoma (adenomyosis) is one of the most common diseases of the female genital area. It is ranked 5th in terms of frequency. Benign tumors are of two types. The first is a leiomyoma growing from the muscle layer. The second is fibroma, which grows from two types of tissue - connective and muscular. It is also called mixed. The size of the tumor is usually denoted by weeks of pregnancy.

The causes of this pathology have not been precisely established. There are factors that contribute to the occurrence of the disease:

• diagnostic curettage;
• abortions;
• hormonal disbalance;
• chronic inflammation of the pelvic organs;
• poor nutrition;
• heredity.

Signs of the formation of myomatous nodes are:

The difficulty in diagnosing fibroids is that the initial stage of the disease does not manifest itself. Symptoms are not pronounced, and a woman can endure discomfort for a long time, not knowing what they are connected with. The tumor is discovered by chance during a physical examination.

Using the manual method, it is possible to suspect the presence of a nodular form of fibroids in the uterus, but then you need to be examined in more detail.

There are known cases of malignant degeneration of fibroids, so it is necessary to control the growth of the tumor with the help of an ultrasound machine or MRI.

Myomatous nodes - what types of examinations are needed

To plan treatment, you need to pass tests:

• blood for hormones;
• blood chemistry;
• blood on, if there is a suspicion of a dangerous degeneration of tissues, since a fast-growing fibroid may turn out to be a sarcoma;
• tissue analysis for histological examination.

The most informative is the ultrasound method and magnetic resonance imaging.

• During the initial examination, ultrasound is performed by the transabdominal method. This makes it possible to see the nodes formed in .
• A transvaginal examination may be recommended to clarify the diagnosis. The procedure is performed with a vaginal internal scanner.
• Ultrasound scanning, in which the sensor is located inside the uterus, allows you to see the mucous membrane and the number of nodes that are located close to the endometrium.

Indications for ultrasound:

Deciphering the readings of the ultrasonic scanner makes it possible to:

Uterine fibroids on ultrasound are visible as a dark area. The more such spots on the monitor, the more neoplasms there are in the uterus.

The MRI method is more expensive, but it allows you to see the exact location of the fibroid, especially if there is more than one node and a gynecological operation is planned.

Timing of ultrasound examinations

Women do ultrasound with uterine fibroids on the 5th - 7th day of the cycle. This is due to the fact that the thickness of the endometrium these days is the smallest. Further, there is a gradual thickening of the mucosa, and it will be more difficult to determine the presence of tumors. Small knots are practically invisible. Therefore, the onset of the disease can be missed.

Important! After the 10th day of the cycle, it is impossible to do an ultrasound with uterine myoma. The exception is submucosal fibroids, which are best seen when the endometrium is enlarged.

The second reason why examinations are not carried out in the second phase of the cycle is high level progesterone, which provokes an increase in tumors. In this case, the readings will be incorrect.

The process of preparing for an ultrasound examination is simple. Depending on the type of equipment in medical institution, your doctor may recommend drinking plenty of water and filling bladder. Or vice versa - go to the toilet.

Transvaginal examination can be painful, so it is recommended to take sedatives or pain medications.

This type of examination has the following advantages:

• has no contraindications;
• you can prepare quickly;
• the conclusion is issued immediately;
• can be done frequently
• in parallel, it is possible to make an examination of all organs of the small pelvis;
• the diagnosis is confirmed with a high probability.

The correct approach to diagnosis and the implementation of the doctor's recommendations regarding the timing increase the accuracy of the diagnosis.

Endometriosis - when to conduct an ultrasound examination

Unlike the diagnosis of fibroids, endometriosis is more suitable for the second phase of the cycle, when the uterus is preparing for the rejection of the mucous layer.

The following facts indicate the presence of endometriosis:

• uneven thickness of the walls of the uterus;
• round shape of the organ;
• an increase in the size of the uterus;
• in the muscle layer, the doctor will see areas with increased echogenicity.

Examination of the ovaries for the presence of cysts should also be carried out in the second half, as they gradually increase in size closer to menstruation.

Treatment for uterine fibroids

Types of treatment for uterine fibroids depend on:

• on tumor size and growth rate;
• how much the tumor bleeds;
• whether it is dangerously located, how many nodes - one or more;
• whether the woman is going to have children in the future;
• at what age is the patient.

Curettage - can it be done with myoma, on what day

Curettage of the uterine cavity is indicated in the following cases:

• the body is weakened by constant bleeding, anemia develops;
• cleaning of the uterine cavity is necessary for cramping pains;
• at accelerated growth tumors;
• it is recommended to remove when a woman is not going to become pregnant;
• when the tumor negatively affects the reproductive function of a woman;
• new nodes appear.

To remove submucosal formations in gynecology, hysteroscopy is most often used - surgical method, based on the transmission of an image of the uterine cavity to the monitor and control over actions using a laparoscope. Can be used for young women.

Myomectomy is done on the 5th - 7th day of the cycle. Previously, it is undesirable, since menstruation interferes with visibility. Later it is not good, because the layer of the endometrium thickens and bleeding may occur, which will have to be stopped during the operation.

Women after it is recommended to remove the uterus if there are a large number of myomatous foci. To avoid relapse. If the uterus is removed, the woman stops menstruating, but the production of hormones continues, so replacement therapy will not have to be carried out.

Preparations

From medical preparations use hormonal agents that normalize the cycle. Help is provided by fortifying agents - vitamins, immunity stimulants, homeopathic preparations.

Diet

• fiber;
• nuts;
• legumes;
• berries - fresh or frozen;
• vegetables fruits;
• greenery is a must.

Fish should be eaten at least 3 times a week. It is advisable to buy fermented milk products at home (difference homemade milk from purchased in the feedstock). The menu should include dietary yogurts that are prepared at home. If you suffer from constipation, then yogurt with dried fruits and bran will help eliminate it and improve bowel function. Description of recipes can be found on any culinary forum.

conclusions

To be cured, it is necessary to be interested in the causes of the disease and do everything to eliminate them. Regular examinations by a gynecologist can eliminate the disease on initial stage which will require much less manpower and resources.

Video: What day after menstruation do ultrasound?

Video: Ultrasound of the uterus

Video: ultrasound - pregnancy with uterine fibroids. Multinodular fibroids

Uterine fibroids are a type of benign tumor formed in the layers of the uterine muscles. The development of this disease is not very fast. The muscle cell will then divide, creating tumor cells. In turn, the tumor cells eventually turn into a special node - myomatous. The symptomatology that accompanies such a disease is profuse bleeding, pain of a “pulling” nature, felt in the lower abdomen, and impaired urination. In especially severe cases, fibroids lead to the development of female infertility. Not only an examination by a gynecologist will help determine fibroids, but also an ultrasound procedure.

When the suspicion of doctors stops at uterine fibroids, a preliminary history should be taken before a professional examination. Special attention given to the following factors:

• the beginning of menarche;
• the presence of abortions and their number;
• transferred childbirth and complications that arose during them;
• a similar diagnosis in females who are closely related to the patient;
• intrauterine interventions for the purposes of diagnosis or treatment;
• ever transferred diseases of an infectious nature that relate to the female genital area.

Another important factor is a clear determination of the severity and determination of the exact period of blood loss during menstruation.

Ultrasound for uterine fibroids provides the most accurate determination of the size and location of fibroids. To visualize the tumor and correctly evaluate its features, one of two possible types of sensors can be used:

• Transvaginal (a special device is inserted into the vaginal cavity)
• Transabdominal (examination is carried out externally, through abdominal cavity without first emptying the bladder).

A special type - hysterography - involves the introduction of an additional (contrast) substance into the uterine cavity, and then the passage of x-rays.

At the core ultrasound lies echolocation. This means that reflected from internal organs the beams arrive at a computer, on the screen of which their exact image is gradually projected.

The ultrasound scanning technique is used when it is necessary to monitor tumor growth and control the effectiveness of treatment.

During the ultrasound procedure, the following occurs:

• Measurement of all available organs in size.
• Estimation of their structure.
• Evaluation of the conformity of the menstrual phase.

Even with small sizes (about 1 cm), after ultrasound, uterine fibroids will be detected. With sizes of 0.5-1 cm, specialists usually monitor the further development of the node.

Deadlines for the procedure

As for the timing, with the diagnosis of uterine fibroids - when to do an ultrasound, the patients ask?

The first ultrasound procedure can be performed on any day, except for the days of menstrual bleeding. The greatest preference is still given to the first phase of the cycle.

If the ultrasound results are inaccurate, it may be re-scheduled. In this case, it is better to adhere to the exact observance of the deadlines. Control diagnostics is carried out once, less often - twice during the calendar year.

Varieties of ultrasound examinations

Recently, the possibilities of research using ultrasound have expanded significantly. Besides that in in general terms type of uterine fibroids on ultrasound, it became available to study the flow of blood inside the tumor itself. For this, three-dimensional images obtained from such procedures are used:

• echographic study;
• dopplerography.

Variety computed tomography or MRI (magnetic resonance imaging) is used for such purposes:

• clarification of the structure of the node formed during the development of fibroids;
• differential diagnosis (comparison with adenomyosis).

In the case when there is a suspicion of a submucosal location of the fibroids, methods such as:

• endoscopy;
• x-ray examination.

If the fibroid is subserous, there are nodes with "legs" or it is necessary to assess the condition of all organs located in the small pelvis - laparoscopy is performed.

It is strictly required histological examination. It is it that is able to fully, 100% confirm the result of ultrasound-uterine fibroids. Based on the results of such an examination, a subsequent course of treatment and forecasting will be built.

With a combination of fibroids and pregnancy, studies allow:

• identify a fetal egg by ultrasound (uterine fibroids may not be noticeable);
• discover by biochemical analyzes blood or urine chorionic gonadotropin ( clear sign myoma development).

Surgical removal of fibroids in women who do not plan to become pregnant does not always make sense. Instead, modern experts suggest doing uterine artery embolization (UAE).

Features of the ultrasound

Ultrasound manifestations of fibroids include the following:

• uneven uterine contours;
• shifted median M-echo.
• the presence of special structures that have an ovoid (round) shape and increased echogenicity (both in the myometric thickness and in the cavity).

The advantages of a three-dimensional echographic study are as follows:

• layer-by-layer careful analysis;
• the reconstruction is taking place on a multifaceted basis;
• retrospective display of data obtained during the survey.

This method makes it possible to most accurately identify the location and number of myomatous nodes, and also shows their relationship with the vessels, the uterine cavity and the cervix. Such details are of great importance in surgical intervention.

Diagnosis of fibroids is not a reason to panic at all. About 40% of modern women have such education. With regular visits to the gynecologist and timely ultrasound, you can confidently guarantee that the development of fibroids will be favorable. Such measures help to avoid surgical intervention, limiting the course of hormonal drugs.

The use of a variety of diagnostic ultrasound methods in combination is possible only in a high category clinic. This step makes it possible to predict in detail the course of the disease and to differentiate the method of treatment.

Uterine fibroids are among the top five diseases of the female reproductive system. Most often, this benign tumor occurs in women over 40 years old, but young women 20-30 years old are not immune from fibroids. One of the main methods for diagnosing this pathology is ultrasound. But in order to correctly diagnose and adequately assess the size and location of myomatous nodes, ultrasound must be done on a strictly defined day of the menstrual cycle. A little preparation is also needed, depending on the type of procedure.

What is uterine fibroids?

Myoma is a benign tumor of the middle (muscular) layer of the uterus - myometrium. There are tumors exclusively from intramuscular fibers (leimomyoma) and mixed, from connective and muscle tissue(fibroma).

There are different data regarding the frequency of development of such tumors. In women over 40 years old, they appear in 40% of cases, in 20-30 years old - in 15-20% of cases. The most dangerous are fibroids, which are diagnosed during pregnancy. When the tumor is large, it can lead to miscarriage or even provoke congenital anomaly fetus due to pressure on the uterus.

The exact causes of this gynecological pathology still not found. The main risk factors that can lead to a tumor are:

• hormonal failure (imbalance of sex hormones);
• inflammation of the uterus in the history of the patient;
• transferred gynecological operations (curettage, abortion, etc.);
• genetic predisposition;
• malnutrition and frequent stress.

Indications for ultrasound

Uterine fibroids is a very insidious disease. It can develop for a long time without the slightest symptoms, and only an occasional ultrasound can reveal the pathology. If the doctor suspects a tumor during a routine examination, he will set a specific date for the ultrasound.

But there are also specific signs that, taken together, clearly indicate a leimomyoma or fibroma. These are heavy periods and bleeding in the period between them, severe pain in the lower abdomen and extending to the lower back. If the tumor has grown enough, due to pressure on neighboring organs, problems with defecation and urination appear. The inability to conceive a baby is also one of the signs of a tumor that has appeared in the uterus.

The attending gynecologist will definitely refer the patient to an ultrasound scan with suspected fibroids with the following symptoms and situations:

• upon reaching menopause;
• after a miscarriage or abortion;
• with excessively painful periods;
• if menstruation is very plentiful and long (up to 8-10 days);
• with pulling and cramping pains in the lower abdomen;
• with spotting throughout the cycle.

It is also worth thinking about what day it is better to do an ultrasound when planning a pregnancy in order to exclude all possible pathologies. Also after childbirth. Doctors also recommend prophylactic ultrasound during puberty to find out if there are any beginning deviations in women's health.

Preparation and conduct of ultrasound

When examining the presence of a benign tumor in the uterus, three main methods of ultrasound scanning are used.

• Transabdominal, external, examination (conducted through the anterior abdominal wall).
• Transvaginal, internal, examination (performed using a sensor that is inserted into the vagina).
• Ultrasound scan of the uterus. In this case, the ultrasound probe is inserted into the uterus and saline is added in parallel.

Which diagnostic method to choose, only the doctor decides. So, transvaginal ultrasound is ideal for the early stage of the disease, when the myoma nodes are quite small. Transabdominal scanning allows you to clearly determine the location of the tumor. Scanning of the uterus is usually done when there is a suspicion of a submucosal tumor located as close as possible to the endometrium.

Minimal preparation is required for a gynecological ultrasound. If you have an external scan, you should drink 1.5 liters of water an hour and a half before the procedure so that the bladder is full. Before a transvaginal examination, on the contrary, you need to go to the toilet to empty your bladder.

Before an ultrasound scan of the uterus, the preparation is the same as before the transvaginal one. Sometimes the doctor advises the patient to take a sedative or pain reliever before the procedure to eliminate possible slight discomfort.

How to choose a day for an ultrasound?

But the most important preparation for ultrasound in the presence of myomatous nodules is the choice of the right time for the procedure.

What days of the monthly cycle are best suited for ultrasound with a myomatous tumor? Doctors in this regard are unanimous: the analysis should be done in the first half of the cycle, immediately after the end of menstruation. The ideal days are the 3rd-5th, but usually an ultrasound is prescribed on the 5th-7th. After the 10th day, an accurate diagnosis of a uterine tumor is no longer possible.

There are two reasons for this strict time frame.

The first one is in initial phase cycle, the endometrial layer is very thin, so even small nodes can be easily seen. Then the endometrial layer thickens, and by the end of the cycle, even peculiar folds are formed. In them, the tumor is easily hidden from the sharp "look" of the ultrasound machine. In addition, during this period, an enlarged ovarian follicle or corpus luteum can be mistaken for a myomatous node.

The second reason is hormonal. In the luteal phase, the production of the hormone progesterone increases, which can provoke a tumor of the myomatous nodes. And when the nodes are enlarged, ultrasound gives an incorrect idea of ​​\u200b\u200btheir condition and localization.

The only exception is submucosal fibroids - it is sometimes recommended to do it on the 19-24th day. In this case, the thickened endometrium, on the contrary, helps to correctly diagnose the tumor.

Based on the results of the diagnosis, a decision is made on further treatment. Ultrasound shows an objective picture - the state of the female reproductive system, what damage was found in it.

Ultrasound of the uterus is prescribed for the following indications:

• every six months - for preventive purposes;
• if a woman is planning a pregnancy and it is necessary to get a general picture of the condition of the appendages;
• postpartum period (in order to exclude pathologies that often “attack” women after childbirth);
• reaching the age of menopause (if there is a fibroid, it can decrease and disappear from view, and later transform into uterine sarcoma);
• puberty of a teenage girl (determine if there are any initial deviations - and they are possible due to poor ecology, increased stress factor, a number of genetic abnormalities);
• painful menstruation;
• a previous abortion or miscarriage;
• excessive duration of menstruation (over 8-10 days);
• cycle failures (including too short breaks between periods);
• cramping pains in the lower abdomen and in the side;
• drawing pains in the lower abdomen;
• infertility;
• spotting in the intervals between menstruation of different cycles.

Also, ultrasound of the uterus is indicated three times for pregnant women (at the 12th, 23rd and 30th weeks).

How is the procedure

Ultrasound of uterine fibroids is not only the visual side of things. Of great importance are the genetic characteristics of a woman, her sex life, past experience (problems and difficulties associated with the uterus).

Myoma behaves insidiously: initially it does not manifest itself in any way (according to statistics - in 85 cases out of a hundred). And even at serious stages, when the only way out is surgical intervention. And it, in turn, is dangerous for female infertility after surgery.

During the procedure, the specialist should pay attention to the following points:

• enlarged uterus;
• uneven contours of the uterus;
• the presence in the cavity or muscle layer of rounded structures;
• location of fibroids.

Survey

The doctor should clarify, and the woman should provide reliable information:

• about the beginning and nature of menstruation;
• whether the woman had had abortions in the past (and if so, how many, any information about the consequences that took place);
• about the number of births, what were the complications during childbirth;
• whether there is information about fibroids in other women in the family.

Exhaustive information is expected from the woman. The patient herself is also interested in this, because according to the results of the examination, it will be easier to prescribe the optimal treatment.

visual inspection

Along with the survey, the doctor examines the skin and mucous membranes. Quite often, just above the pubis, an enlarged area is determined by palpation of the abdomen. True, this symptom is not decisive - the presence of fibroids is possible even in the absence of its signs during palpation.

Hardware ultrasound of the uterus

Transabdominal examination:

• the scanning device works through the abdomen;
• there is no penetration into the vaginal cavity;
• at the same time, not only the uterus is examined, but also the appendages (ovaries);
• for better signal permeability, a special gel is used (applied to the lower abdomen and to a sensor that emits ultrasound).

Transvaginal examination:

• the equipment signal is more sensitive;
• the result is more accurate;
• the pelvic organs (in addition to the uterus) are also examined;
• a small probe penetrates the vaginal cavity.

Both procedures are completely painless. Modern equipment allows:

• study in detail the nature of the blood flow inside the fibroids;
• accurately determine the location of the tumor, its size;
• get an objective picture.

Based on the results of the ultrasound, a decision is made on further measures. The task is to prevent the degeneration of a benign tumor (which is a fibroid) into a malignant one. In most cases, patients are assigned a histological examination (hysteroscopy) of fibroids.

Hysteroscopy- a method of minimally invasive examination of the uterine cavity using a hysteroscope, followed by diagnostic and surgical manipulations.

Hysteroscopy allows you to identify and eliminate intrauterine pathologies, remove foreign bodies, take tissue biopsies, and remove endometrial polyps. During the examination, surgical procedures are available to eliminate uterine causes infertility - endometrial polyps, submucosal myoma nodes, hyperplastic foci of the endometrium, intrauterine synechia and septa.

It is also possible to recanalize the fallopian tubes and evaluate their mucous membrane up to the fimbrial region.

Preparing for an ultrasound examination of uterine fibroids

Preparatory measures depend on how the ultrasound is planned to be performed - transvaginally (through the vagina) or transabdominally (outwardly through the skin of the abdomen). And that's why:

• the fact is that ultrasound waves hardly pass through the air, and through dense water - as well as possible;
• accordingly, in the second case, the resulting image of the internal organs will be of the highest quality.

Based on this, the preparation is different:

• when examining through the vagina, the bladder must be emptied (go to the toilet immediately before visiting the doctor);
• during an external examination, it is necessary to drink 1 liter of water 1.5-2 hours before the start of the ultrasound (the bladder should be full until the end of the procedure).

Timing of ultrasound for uterine myoma

The examination should be carried out in a certain period associated with the female menstrual cycle. Only if this condition is met, the result will be as accurate as possible and will give a complete picture of the objective picture.

follicle growth

While a woman is in reproductive age, her menstrual cycle is the basis of the most important physiological phenomenon:

• once during the cycle, the vesicle matures, inside which the egg is contained (such a vesicle is called the dominant follicle);
• the uterine mucosa thickens;
• it produces special substances to support the development of the fetus at the beginning of a potential pregnancy (which is programmed by nature once a month).

Thickness of the endometrium

With uterine fibroids, ultrasound should be done only in the first phase of the menstrual cycle. During this period, the thickness of the endometrium (the inner lining of the uterus) becomes the smallest. That is, if a woman has any pathologies (seals), they will be easier to see than against the background of a thickened endometrium.

If the examination is carried out in the second phase, then the endometrium will be a folded dense tissue - in it small nodules will be completely lost and slip out of sight of even the most sensitive ultrasound equipment.

Optimal time

Timing of ultrasound:

• in order to track the state of the thickness of the uterine muscle, in most cases, ultrasound is performed on days 5-7 of the menstrual cycle (it is counted from the first day when menstruation began). The optimal terms are 3-5 days, but in any case no later than 7-10 days;
• to assess the dynamics of the maturation of the follicle and the work of the ovaries, sometimes ultrasound is performed three times throughout the entire menstrual cycle (approximately from the 8th to the 10th, from the 14th to the 16th and from the 22nd to the 24th day of the cycle) .

In women with an unstable cycle, examination days may be much longer. Every situation is different.

Possible errors in diagnostics

Unfortunately, none of the diagnostic methods is without errors. The following factors can lead to an erroneous interpretation of the results of ultrasound:

• low qualification of the diagnostician (inability to correctly interpret the images obtained during scanning);
• non-compliance with the optimal timing of the ultrasound.

There are cases when fibroids are mistaken for a uterine polyp or vice versa.

Differences between a polyp and a fibroid

• is formed in the muscle of the uterus (that is, it consists of muscle tissue). It grows inside the uterine wall;
• if it appears, it does not disappear by itself in any way - it only increases in reproductive age or, after the onset of menopause, decreases slightly;
• in the early stages they are very small, but developing, they sometimes reach gigantic sizes - with an apple or even a watermelon;
• the chance of transformation from a benign tumor to a malignant one is very high.

• develops on the endometrium (that is, it consists of the mucous tissue of the uterus). A polyp grows on the walls of the fallopian tubes or uterus. In shape, it is a formation on a well-marked thin stalk;
• polyps change their size, sometimes dissolve (that is, disappear without a trace);
• polyps in diameter usually range from 4 to 5 mm (very rarely reach 12-15 cm);
• polyps do not carry cancer risks.

Why is diagnostic accuracy important?

The symptoms of polyps and fibroids are very similar:

• polyps and fibroids are about equally common;
• both can cause vaginal bleeding in the postmenopausal period;
• both involve issues of reproductive capacity.

True, large fibroids additionally cause frequent urge to urinate (this is natural, because there is pressure on the bladder) - and polyps (see above), with their small sizes, do not make themselves felt at all.

To avoid errors in diagnosis, you need to be examined regularly. Many women are careless about their health. But for preventive purposes, you need to undergo an ultrasound scan of the uterus and appendages at least once. If the slightest seals are found, then the doctor will prescribe repeated procedures. They will show the dynamics, establish the nature of the formations (polyp or myoma).

Ultrasound scanning error

Ultrasound examination of the uterus does not guarantee a 100% result the first time. It must be understood that any tumor has an imperfect shape. A two-dimensional projection, especially a one-time one, does not guarantee absolute accuracy.

That is, for example, if today an ultrasound scan showed dimensions of 26 mm, and in the next cycle 29 mm, this is not a reason to draw a final conclusion about the rampant growth of the formation. Given the measurement errors, you need:

• at a minimum, be examined several times and carefully examine multiple images (obtained by scanning);
• at least 1-2 times against MRI (3D image will show the shape of the fibroids in different projections).

The cost of an MRI examination is much higher. Therefore, they are resorted to only in cases where there is an alarming reason to clarify the result of an ultrasound scan.

Myoma of the uterus, also known as fibromyoma, is a benign tumor of the muscular or musculo- connective tissue. Often, patients, when they are given such a diagnosis, panic, confusing fibroids with cancerous tumors. chief diagnostic method if this disease is suspected, an ultrasound examination is performed.

Uterine fibroids are formed as a result of sudden and uncontrolled division muscle cells uterus. No one has yet identified the exact causes, but according to modern concepts, this tumor belongs to hormonal ones. Hormones that play an important role in pathogenesis are estrogens, which explains the prevalence of women mainly between the ages of 25 and 40, since it is at this age that hormonal disruptions occur that can lead to fibroids. Every fifth woman under the age of 30 has uterine fibroids.

Symptoms

In the treatment of uterine fibroids, it is important to identify it in time in order to prevent new tumors from appearing, since 2 or more neoplasms are often found. Ultrasound of uterine fibroids is used as a diagnosis, but although this method is performed quite quickly, self-diagnosis of the patient is very important. Those prone to this disease are:

• women with a hereditary predisposition;
• suffering from infertility;
• having disruptions in the menstrual cycle;
• sick diabetes, obesity, or other metabolic disorders;
• with multiple;
• under constant stress.

The first symptoms in which a woman may suspect that she has uterine fibromyoma are abundant bloody issues with menstruation and cycle disorders. Another common symptom is periodic pain lower abdomen.

Uterine fibroids can sometimes not disturb at all and be discovered by accident. But there are a number of rather serious complications that should be considered when comparing the signs and symptoms indicated earlier. Since one of the symptoms is bleeding, patients develop chronic Iron-deficiency anemia. Fibroids can interfere with conception and childbearing and are sometimes discovered during infertility testing. The pain appears due to compression of the surrounding organs by the tumor, if the growth of the fibroids is directed to. Sometimes compression by the tumor leads to constipation. The most dangerous complication is the torsion of the "legs" of the tumor.

Diagnostics

The main method used to detect uterine fibroids is ultrasound. , making it possible to diagnose many various diseases: inflammatory diseases, tumors, cysts, malformations, ectopic pregnancy, etc.

There are three types of ultrasound diagnostics of uterine fibroids:

1. The first method is called -. It is carried out by ultrasound diagnostics through the anterior abdominal wall.
2. The second method is . To perform this method, it is necessary to insert a special ultrasound probe into the vagina.
3. The third method is performed by introducing a special solution into the uterus and is called ultrasound scanning.

The choice of the method of conducting should be decided solely by the doctor.

Myomatous nodes can be located in different parts of the uterus. Most often they are localized in the muscle layer, where they provoke one of the most common symptoms - bleeding. If the node is located in the area, then it will interfere with childbirth (therefore, it is very important to carry out). There is another important detail - the thickness of the base of the fibroids. The thinner the base ("leg"), the higher the chance of its torsion. An ultrasound examination will help determine the location and the tumor itself, and the most modern devices determine the blood circulation inside the neoplasm.

Uterine fibroids on ultrasound are a clear rounded formation, which is delimited from the healthy tissues surrounding it. The nodes have a layered structure and a pseudocapsule. The degree of echogenicity, i.e. the visibility of the tumor on ultrasound depends on the composition of the tissues in the tumor. The higher the proportion of connective tissue, the less sound-conducting the tumor. If areas with reduced sound conductivity are found in the node itself, then this indicates the presence of foci of necrosis (death) or the formation of cysts. Necrosis may indicate torsion of the tumor stem. Assessing the features of the growth and location of the foci, the doctor can predict the further development of the pathology.

With uterine fibroids, an ultrasound scan is simply necessary, but in the case of poor sound conduction, MRI can also be used for detailing.

At ultrasound diagnostics, it is possible to estimate the number of nodes, their diameter and localization, which can fundamentally affect the tactics of treating the patient. In addition to neoplasms, ultrasound determines the condition of the uterus. The body and neck are determined.

Preparing for an ultrasound

The study is being conducted with little preparation. Often, the study can be performed immediately upon admission. If a transvaginal or ultrasound scan is planned, then the patient must first go to the toilet and empty. These methods of research can be accompanied by discomfort, and in some cases are painful, so the doctor may recommend taking a sedative or pain reliever. As for the transabdominal examination, then the patient, on the contrary, needs to drink about one and a half liters of water in order to fill the bladder.

On what day of the cycle to do ultrasound of uterine fibroids

Since uterine fibromyoma is a hormone-dependent tumor, its activity is associated with. The fact is that in the body of a woman, depending on the phase of the cycle, the concentration of progesterone in the blood also changes. Accordingly, in the second phase of the cycle, the fibroids will be more edematous. If the study is performed after a certain interval during one cycle, then the size of the fibromyoma can seriously differ.

Often, at the first examination, ultrasound of the fibroids is performed regardless of the current day. If the gynecologist believes that the study is not informative enough, then it is chosen on which day to do an ultrasound scan of the uterine fibroids in advance and in advance. In the initial phase of the menstrual cycle, the layer is still very thin, which means it is easier to see the nodes. In the future, the layer thickens and the fibroid becomes much harder to detect. Based on this, the answer to the question: “on what day of the cycle should an ultrasound of uterine fibroids be done?” is from 3 to 5 days of the beginning of the cycle, but due to some features, the study often shifts to 5 or 7 days. The least reliable study is considered to be an ultrasound performed after the 10th day of the cycle.

There are options for the development of nodes, in which it is recommended to conduct an ultrasound as soon as possible. Such fibroids are called submucosal. The peculiarity of the growth of such a tumor lies in its location under the mucous membrane. Therefore, in the diagnosis, a thick layer of the endometrium, on the contrary, will help in the diagnosis. The most optimal days for performing the study are 18-24 days.

Differential Diagnosis

Often there is a need to distinguish between uterine fibroids and other pathologies. The most common diseases with which uterine fibroids have to be differentiated are:

• Sarcoma of the body of the uterus
• Tumors
• Some inflammatory diseases

The very disease that is often confused with uterine fibroids is sarcoma. Sarcoma of the uterus is a malignant tumor of the body of the uterus. Similar to fibroids, it is formed from muscle tissue or endometrial stroma. The most important hallmark, which determines the danger of this disease - cell differentiation. This indicator, which is determined by histological analysis, is the difference benign tumors from malignant ones. With ultrasound, sarcoma can also be suspected, because the cells of which it consists differ in sound conductivity from fibroid cells. Accordingly, with sarcoma, the prognosis for the course and recovery of the patient is much worse.

Ultrasound is an important method for differentiating all other diseases from fibroids. Due to its characteristics, it allows you to assess the condition of tissues, in particular the endometrium. But we must not forget about possible situations when several diseases are combined and lead to blurred clinical picture, at which the most fast method determination of the exact diagnosis is an ultrasound examination.

On ultrasound, it is almost impossible to confuse fibroids with pregnancy, at least because the patient will first be examined by a gynecologist, checking all other signs of pregnancy.

Treatment depends on the results of the studies obtained. Sometimes it is enough to take drugs and fibroids may disappear or decrease significantly. In cases where the tumor is large, it is impossible to do without surgery. The degree of intervention depends on the site of growth and the characteristics of the fibromyoma, because the operation can be either radical (when the uterus is removed) or organ-preserving.

If a pregnant woman has uterine fibromyoma, then she needs special care and supervision. The larger the tumor, the more difficult and dangerous for the fetus will be childbirth. Sometimes a particularly large size of fibroids can affect the intrauterine development of a child, leading to various anomalies. To avoid such consequences, pregnant women need to be monitored in dynamics with the help of ultrasound.

Women often worry about the consequences of having an ultrasound scan and the risks of complications. During ultrasound, the patient is not affected by any rays, as, for example, in x-ray examination. In addition, the method, due to its speed and accuracy in the reliability of the data obtained. On average, the duration of the study takes about 15-20 minutes and everything is immediately recorded in the protocol. The results of the study should only be evaluated by a doctor. Many patients who have had uterine fibroids should have regular ultrasound examinations.