Tratamento endovascular da miomatose uterina: uma revisão sistemática

Costa, Kamilla Rosales; Metzger, Patrick Bastos

doi:10.1590/1677-5449.190149

Cited by 8 publications

(2 citation statements)

References 22 publications

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“…Its incidence varies depending on different factors, including age and ethnicity. 1 These are benign tumors resulting from the growth of muscular and fibrous tissue, which can be embedded or adhered to the uterine wall and their classification varies between submucosal, intramural or subserous depending on the depth they reach. 2 These tumors are responsible for causing numerous clinical problems in women's health, including dysmenorrhea, infertility, and obstetric problems.…”

Section: Introductionmentioning

confidence: 99%

Uterine fibroids: a review

Arguelles-Castillo,

Pérez,

Rojas

et al. 2024

Int Surg J

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Myomatosis of large elements are benign tumors resulting from the growth of muscular and fibrous tissue, which can be embedded or adhered to the uterine wall and their classification varies between submucosal, intramural or subserous depending on the depth they reach. More frequently, symptomatic patients report the presence of abundant abnormal uterine bleeding, dysmenorrhea, dyspareunia and infertility. This pathology represents 40-60% of all hysterectomies, of the total, 30% in women of childbearing age. Different possible triggers of uterine fibroids have been described, which is why it is considered to be of multifactorial origin. Ultrasound is usually used frequently due to its high availability and low cost, this being the first diagnostic image of choice and the gold standard, through transvaginal ultrasound. The management of myomastomas entails a great social problem, since therapy seeks treatment methods that prevent the recurrence of the disease, and in case of satisfied parity, hysterectomy is the ideal option, but in those patients still of fertile age and with desire of pregnancy, less drastic procedures such as myomectomy will be carried out. Finally, some post-surgical complications have been discussed, among which the generation of adhesions due to the scarring resulting from the surgical intervention was described, which could generate infertility or greater difficulty in conceiving.

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Section: Introductionmentioning

confidence: 99%

Uterine fibroids: a review

Arguelles-Castillo,

Pérez,

Rojas

et al. 2024

Int Surg J

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“…2.2 BASES TEÓRICAS2.2.1. FIBROMA UTERINODefinición: Son considerados tumores o neoplasias benignas monoclonales que surgen en el músculo liso uterino específicamente en el miometrio, hallándose compuestas de miofibroblastos sumergidos en abundante cantidad de matriz extracelular representando una parte sustancial de volumen tumoral, es considerada como la causa más frecuente de morbilidad en mujeres en edad fértil 21. 2.2.2.-TEORIAS DE FORMACION DE FIBROMA UTERINO[21][22]…”

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Factores reproductivos y endocrinos asociados a fibromas uterinos en pacientes atendidos en el Hospital Augusto Hernández Mendoza de Ica, 2021 - 2022

Huamani Reyes

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Titulo: Factores reproductivos y endocrinos asociados a fibromas uterinos en pacientes atendidos en el Hospital Augusto Hernández Mendoza de Ica, 2021 – 2022. Objetivo: Determinar la asociación de los factores reproductivos y endocrinos asociados a fibromas uterinos en pacientes atendidos en el Hospital Augusto Hernández Mendoza de Ica, 2021 – 2022. Material y Métodos: Estudio no experimental de alcance relacional, transversal y retrospectivo, con diseño de casos y controles, se obtuvo 56 casos y 112 controles (relación 1:2) mediante muestreo probabilístico simple, los datos se registraron en una de ficha de recolección. Resultados: Los de mayor porcentaje en las características de la población de estudio se tiene que la edad está en etapa fértil (20 a 39 años) con 54.8%, educación superior de 48.8%, estado civil casada con 34.5% y divorciada (32.1%), de ocupación independiente (51,2%). Los datos de los factores en los casos se tiene que 71.43% son nulíparas,16.02% uníparas y 12.5% multíparas, la edad reproductiva es un 67.90%, en cuanto al aborto el 35.7% la presentó, la menarquia temprana fue de 33.9% y el 71,4% empleó anticonceptivos hormonales. En cuanto asociaciones significativas la paridad mostro un p< 0.001) con un OR= 15, IC95=[6.842-32.886],con el aborto (p=0,002) y un OR=2.888 IC95= [1.484 -5-623], con la menarquia temprana (p=0,000) y OR= 2.46 , IC95=[1.05-4.89] y no mostraron asociación con el fibroma uterino, la edad reproductiva (p=1.148) y el uso de anticonceptivos hormonales (p=0.057) Conclusiones: Al utilizar la regresión logística binaria para detectar falsa asociaciones se concluyó que los factores endocrinos y reproductivos asociados a fibroma uterino son la paridad y la menarquia temprana en las pacientes atendidas en el hospital Augusto Hernández Mendoza de Ica, 2021-2022.

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Uterine Artery Embolization Versus Hysterectomy in Postpartum Hemorrhage: A Systematic Review With Meta-Analysis

Fernandez,

Coutinho de Carvalho,

Martins

et al. 2024

J Endovasc Ther

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Purpose: The objective of this study is to perform a meta-analysis comparing the effectiveness of uterine artery embolization (UAE) versus peripartum hysterectomy for acute refractory postpartum hemorrhage (PPH) control. Materials and Methods: We systematically searched 6 medical databases for studies comparing UAE and hysterectomy in PPH. Outcomes examined were mortality, hospitalization duration (HD) in days, and red blood cells (RBC) units utilization. Statistical analysis used RevMan 5.1.7 and random-effects models. Odds ratios (OR) and mean differences (MDs) with 95% confidence intervals (CIs) were used for dichotomous and continuous outcomes, respectively. Results: We included 833 patients from 4 cohort studies, with 583 (70%) undergoing UAE. The UAE population required fewer RBC units (MD: −7.39; 95% CI: −14.73 to −0.04; p=0.05) and had shorter HD (MD: −3.22; 95% CI: −5.42 to −1.02; p=0.004). Lower mortality rates were noted for UAE in the pooled analysis, but no statistical significance. Uterine artery embolization demonstrated lower procedural complications (16.45% vs. 28.8%), in which UAE had less ureter and bladder lesions (OR: 0.05; 95% CI: 0.01-0.38; p=0.004 and OR: 0.02; 95% CI: 0.00-0.15; p<0.001, respectively). Only 35 (6%) required conversion to hysterectomy, while 27 (4.6%) underwent re-embolization with 100% bleeding control. Uterine artery embolization did not hinder fertility, with normal menstruation restored in 19 patients with postoligomenorrhea. Conclusion: Uterine artery embolization for the control of PPH is associated with lower use of RBC units and HD, but similar rates of mortality are noted when compared to hysterectomy. These results associated with uterine preservation could support its importance for refractory PPH management. Clinical Impact Uterine Artery Embolization is associated with a shorter hospitalization duration and reduced use of red blood cell units when compared with hysterectomy in refractory postpartum hemorrhage. Although demonstrating similar mortality rates, these findings, together with fertility preservation, support the method incorporation as a valuable option in obstetric services.

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Tratamento endovascular da miomatose uterina: uma revisão sistemática

Cited by 8 publications

References 22 publications

Uterine fibroids: a review

Uterine fibroids: a review

Factores reproductivos y endocrinos asociados a fibromas uterinos en pacientes atendidos en el Hospital Augusto Hernández Mendoza de Ica, 2021 - 2022

Uterine Artery Embolization Versus Hysterectomy in Postpartum Hemorrhage: A Systematic Review With Meta-Analysis

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