Ultrasound Evaluation Of Uterine Fibroids Among Women Of Child Bearing Age: A Single Centre Study In Port Harcourt Metropolis

Abstract

BACKGROUND: Uterine fibroid has been reported as the most common benign gynaecological tumour affecting women of childbearing age globally, with an estimate of 9 million cases being diagnosed in 2019 alone. Uterine fibroid is one of the major problems affecting women. Understanding the most common type of uterine fibroid, region of the uterus mostly affected and the most affected age group is essential.

OBJECTIVE: To evaluate the prevalence of uterine fibroid in Port Harcourt Metropolis using ultrasound scan.

METHODS: The study conveniently assessed a total of 1575 women aged from 18 to 55 years referred for pelvis/abdominopelvis ultrasound scan in a selected healthcare facility/radio-diagnostic centre in Port Harcourt, Nigeria from October, 2023 to March, 2024. The study adopted a prospective descriptive research design using a Mindray DP-2200 with a 3.5MHz transducer. Each patient was made to lie down on a couch and a generous amount of ultrasound gel applied on the lower abdomen. The 3.5MHz transducer was used to scan after which, sections of the pelvis indicating uterine fibroid imaged. The uterus was visualized as a pear-shaped anteverted structure superior to the vagina and posterior to the urinary bladder and having different echogenicity according to the phase of the menstrual cycle while the uterine fibroids were identified ultrasonically as distinct ovoid echopenic nodular masses. The type, site/location of the uterine fibroid including age group distribution were data obtained from the scanned women following ethical approval with their consent sought. Analysis was done using the statistical package for social science Inc, Chicago, IL, USA, version 26.0.

RESULTS: The most common type of uterine fibroid observed was the intramural, accounting for 61.9% cases while submucosal fibroids (5.4%) and the pedunculated type of myoma (4.0%), revealed a comparatively lower occurrence within the population under study. The exact location of the uterine fibroid on the walls of the uterus showed the anterior wall with the highest frequency closely followed by the antero-fundal wall while the lowest frequency was observed in the posterior and postero-fundal walls. Age group distribution showed that women within the age range of 31-35 had the highest frequency of 26.4%, followed by those between 36- 40 with 24.2%. Those with the lowest frequency were between the age range 51-55 years.

Conclusion: Ultrasound evaluation demonstrates intramural type of fibroids located mostly in the anterior wall of the uterus, prevalent in women of age group 31 to 35 years in the studied population. Thus, the role of ultrasound in the diagnosis of uterine fibroids cannot be overemphasized.