ANALYSIS OF HUGE POSTERIOR CERVICAL FIBROIDS IN GYNECOLOGICAL PATIENTS IN A TERTIARY CARE HOSPITAL: A RETROSPECTIVE STUDY

Dr. Paribhashita T. Mishra*, Dr. Udit Mishra and Dr. V. P. Singhal

ABSTRACT

Fibroids are frequently encountered, however posterior cervical fibroids are rare, especially of enormous size that are very rarely seen in modern era. These are usually associated with pressure symptoms on bladder, urethra, rectum or obstruction of ureters may be seen which leads to obstructive nephropathy necessitating its early removal. The aim and objective of this study was to find out the prevalence of cervical fibroid in hospital admission in tertiary care hospital and studying operative difficulties and outcome. Out of 182 cases of massive lump abdomen more or equal than 26 weeks gestation size 65 (35.71%) had huge leiomyoma, out of which 17 (26.67%) cases were of huge posterior cervical fibroids. Out of 17 cases four patients underwent myomectomy as 3 and 1 were unmarried and married respectively but nulligravida. A total abdominal hysterectomy was done in 6 patients and 7 were treated by TAH with bilateral salphingo oopherectomy (BSO). There was no case of any major injury to surrounding organs and no mortality. Blood transfusion was given in 13 patients out of which 10 patients required blood transfusion in imtraoperative and post operative period. Difficulty in delivery was noted in 9 patients for which Parul’s traction device was used. Conclusion- In cervical fibroid very often bladder is stretched and lifted even up to round ligament Caution should be taken while giving incision and parul’s traction device is very useful in delivering compacted cervical fibroids. Adequate care should be taken to avoid injury to ureter(s).

Keywords: Posterior cervical fibroid, Pelvic pressure symptoms, Parul’s traction device.