PREVALENCE AND SONOGRAPHIC PATTERNS OF UTERINE FIBROID AMONG WOMEN OF REPRODUCTIVE AGE IN JOS, PLATEAU STATE, NIGERIA
Background: Uterine leiomyoma represents a major public health problem and is regarded as the most common benign gynecologic tumors affecting premenopausal women. It is associated with considerable morbidity and hospitalization.
Objectives: This research was carried out to establish the prevalence and sonographic characteristics of uterine leiomyoma as well as the histological diagnosis of the tumour among Nigerian women of reproductive age living in Jos Plateau State.
Methodology: This is a prospective cross-sectional hospital based study in which 295 women of the age between 20 years to 50 years was recruited randomly after obtaining an informed consent from each. Abdomino-pelvic ultrasound scan was performed on each participant using a GE Logic 5 machine fitted with 3.5MHz probe with emphasis on the location, number and characterization of uterine leiomyoma(s); thereafter trans-vaginal ultrasound scan using 7.5MHz frequency probe, was done for the subjects that have uterine fibroid for better delineation and location of the mass(es), followed by Sonohysterography where necessary to ascertain its/their location(s). The histologic findings/diagnosis of the tumour post surgery for those who had myomectomy in course of the study was correlated to the sonographic diagnosis. The number of fibroid nodules, location in the uterus, sonographic patterns, classification and histological diagnosis were assessed descriptively and inferentially using the Statistical Package for Social Scientists version 20 (SPSS20). The results were presented in form of tables and charts.
RESULTS: The mean age for the participants was 32.66+7.66 years ranging from 21 to 50 years. The mean age of the sonographically confirmed fibroid cases was 34.99+6.79 years with a range of 21 to 48 years.
The study indicated that 28.33% (83/295) of the subjects had fibroid; the highest prevalence (49.7%) of the fibroid case occurred among women in their fourth decade and the lowest (8.4%) at the extremes of reproductive age. A significant positive association (P=0.043) between nulliparity and the presence of fibroid was noted. The average number of fibroid nodules and volume of the largest nodule were estimated as, 2.76+1.93 and 344+69.24cm3 respectively; 57.80% of the fibroid were intramural with only 9.6% been submucosal. Most (86.70%) of the fibroids were located within the uterine corpus and the most common (38.6%) sonographic pattern of the nodules was hypoechoic. The histological findings post myomectomy for those that had surgery in the course of the study showed no evidence of malignant transformation.
Conclusion: The prevalence and sonographic pattern of leiomyoma among women of reproductive age in Jos have been assessed; it was found that characteristics of the fibroid and its location determine the clinical presentation and possibly the reproductive outcome of the patient; this could help in appropriate management of cases in the North-Central or the whole nation.