mioma uterino
DESCRIPTION
Miomas UterinosTRANSCRIPT
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MIOMA UTERINO
Prof. Claudia Gutiérrez M.
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DEFINICION:
Tumor benigno formado por fibras musculares
lisas y tejido conectivo.
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•El 90% corresponden tumores benignos
•Frecuencia de 1 en 5 mujeres
•Se presenta en el 25-40% en mujeres
•Se manifiesta en grupo etario de los 35-50 años
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CLASIFICACION:
Mioma uterino: único
Miomatosis uterina: varios• Leiomiomas: músculo liso• Fibromas: tejido conectivoFibromas: tejido conectivo
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UBICACIÓN:Miomas Submucosos (15-25%)
Miomas Subserosos (10%)
Miomas Intramurales (60-70%)
Miomas del Cuello
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Mioma subserosos
Mioma del cuello uterino o pólipo
Mioma Submucosos
Mioma intramurales
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Fibras Musculares Inmaduras
Células en Hiperplasia
Nódulo
Pedículo
PATOGENIA
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DEGENERACION DEL MIOMA:• Postmenopáusicas
• Necrosis
• Sarcomatosas
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MALIGNIZACION• 0.1- 0.5% miomas extirpados• Postmenopáusicas y ancianas• Sospecha:
– crecido– metrorragia
• Dg:– metastasis– invasión local – histológico
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SIGNOS Y SINTOMAS
• Sintomáticos (20-40%)
• Asintomáticos (15-20%)– 10 a 12 sem. se operan (el tamaño
del mioma es equivalente a la semanas de gestación)
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• Alteraciones menstruales (el mioma intramural es el que más sangra)
• tumoración abdominal palpable• dolor tipo pesadez• flujo vaginal• molestias de compresión• esterilidad e infertilidad• síntoma secundario: ANEMIA
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DIAGNOSTICOTacto Bimanual
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Ultrasonografía
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Laparoscopía
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Biopsia
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DIAGNOSTICO DIFERENCIAL:• Embarazo complicado• Tu. ováricos• Procesos adherenciales anexiales• Tu. malignos del útero• Tu. benignos del útero• Mola
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TRATAMIENTOEXPECTANTE:• asintomático • pequeño (>12 SEM.)
Médico:• agonista GnRH (luprón- Acetato de
Leuprolide
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TRATAMIENTO QUIRURGICO• Histerectomía total (mujeres con
paridad completa)• HT total + SOB (paridad completa)• Miomectomía
– jóvenes – nuligestas– deseo de embarazo– infertilidad
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Mioma
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Mioma visto bajo histeroscopía
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Mioma visto bajo laparoscopía
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Mujer con un mioma >12 semanas
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MIOMA Y EMBARAZO
• Se presenta en el 1% de las embarazadas
• Aumento el tamaño en un 50-70%• Alterar la evolución del embarazo:
– síntomas de aborto – parto prematuro– disrrelación entre A.U. y E.G.– subinvolución uterina– abdomen agudo
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