ULTRASONOGRAPHIC EVALUATION OF FIGO CLASSIFICATION TO PREDICT ABORTION AND INFERTILITY IN MARRIED FEMALES
DOI:
https://doi.org/10.71000/cfgnxv26Keywords:
Abortion, Fertility, FIGO Classification, Infertility, Leiomyoma, Ultrasonography, Uterine FibroidsAbstract
BACKGROUND :Uterine fibroids or leiomyomas, are benign growth that commonly affect women, particularly during their childbearing years. By menopause, over 70% of women may develop these growths, which can lead to issues like heavy menstrual bleeding and infertility. The FIGO classification system categorizes fibroids into nine types based on their location in the uterus, helping healthcare providers make informed treatment decisions. This standardized approach improves communication and enhances patient care by addressing variations in ultrasound reporting and guiding therapeutic options effectively.
OBJECTIVE: To evaluate uterine fibroids with FIGO classification and predict abortion and infertility in married females.
MATERIAL AND METHODS: This cross sectional analytical study included 120 married females who had fibroids in their uterus.This study was conducted at Bajwa Hospital. Data was analyzed using SPSS version 25.
RESULTS: Out of 120 patients, 34 females have submucosal fibroids, 47 has intramural while 39 have subserosal fibroids. According to the location, 3 are fundal, 57 are anterior, 48 are posterior, and 12 are lateral.
CONCLUSION:Our research indicates that intramural fibroids are the most frequently occurring type among patients, particularly those located in the anterior part of the uterus. This suggests that women with these fibroids may experience specific symptoms due to their location. Understanding the type and location of fibroids is crucial, as it can help healthcare providers develop effective treatment plans tailored to alleviate symptoms and improve patient quality of life.
Background: Uterine fibroids, also referred to as leiomyomas, are the most common benign tumors of the female reproductive tract, affecting up to 70% of women by menopause. They often manifest during the reproductive years and may lead to heavy menstrual bleeding, pelvic pain, infertility, and adverse pregnancy outcomes. The International Federation of Gynecology and Obstetrics (FIGO) classification system provides a standardized approach to categorizing fibroids based on their anatomical location within the uterus, thereby improving diagnostic consistency, guiding treatment decisions, and enhancing patient outcomes.
Objective: The objective of this study was to evaluate uterine fibroids using the FIGO classification system and determine their predictive role in abortion and infertility among married women.
Methods: This cross-sectional analytical study was conducted at Bajwa Hospital and included 120 married females diagnosed with uterine fibroids. Participants were selected using non-probability convenient sampling. Women with endometriosis, leiomyosarcomas, prior hysterectomy, or those unwilling to provide informed consent were excluded. Clinical assessment and ultrasound were performed to document fibroid type, location, and FIGO classification. Data were analyzed using SPSS version 25, with descriptive and inferential statistics applied to evaluate distribution and associations.
Results: Among 120 participants, 34 (28.3%) had submucosal fibroids, 47 (39.2%) had intramural fibroids, and 39 (32.5%) had subserosal fibroids. Based on anatomical distribution, 3 (2.5%) were fundal, 57 (47.5%) anterior, 48 (40.0%) posterior, and 12 (10.0%) lateral. According to FIGO staging, the most frequent was stage 4 (32.5%), followed by stage 0 (23.3%) and stage 6 (21.7%). A history of abortion was reported in 56 women (46.7%), while 91 women (75.8%) reported pain, 33 (27.5%) reported menorrhagia, and 39 (32.5%) experienced oligomenorrhea. At the time of assessment, 12 women (10.0%) were pregnant.
Conclusion: The findings demonstrate that intramural fibroids, particularly those located in the anterior uterine wall, were the most prevalent and carried significant reproductive implications. Recognizing fibroid type and location through the FIGO classification system is essential for predicting abortion and infertility risk, enabling healthcare providers to tailor management strategies that improve both reproductive outcomes and overall quality of life.
References
Bajaj S, Gopal N, Clingan MJ, Bhatt S. A pictorial review of ultrasonography of the FIGO classification for uterine leiomyomas. Abdominal Radiology. 2022 Jan 1:1-1..
Sefah N, Ndebele S, Prince L, Korasare E, Agbleke M, Nkansah A, Thompson H, AlHendy A, Agbleke AA. Uterine fibroids—Causes, impact, treatment, and lens to the African perspective. Frontiers in pharmacology. 2023 Jan 10;13:1045783.
Olotu JE, Okon M. Anatomical location of uterine fibroids among women attending a tertiary health facility in a southern Nigerian population. GSC Biological and Pharmaceutical Sciences. 2021;14(2):007-15.
Palheta MS, Medeiros FD, Severiano AR. Reporting of uterine fibroids on ultrasound examinations: an illustrated report template focused on surgical planning. Radiologia Brasileira. 2023 May 8;56(2):86-94.
Don EE, Landman AJ, Vissers G, Jordanova ES, Post Uiterweer ED, de Groot CJ, de Boer MA, Huirne JA. Uterine fibroids causing preterm birth: a new pathophysiological hypothesis on the role of fibroid necrosis and inflammation. International journal of molecular sciences. 2022 Jul 22;23(15):8064.
Freytag D, Günther V, Maass N, Alkatout I. Uterine fibroids and infertility. Diagnostics. 2021 Aug 12;11(8):1455.
Frijlingh M, Juffermans L, De Leeuw R, De Bruyn C, Timmerman D, Van den Bosch T, Huirne JA. How to use power Doppler ultrasound in transvaginal assessment of uterine fibroids. Ultrasound in Obstetrics & Gynecology. 2022 Aug;60(2):277-83.
Subramaniyam NK, Kandluri V, Chadeve A, Modapu D, jyothi Dumpala A, Gudise BR, Palei NN, Kumar BJ, Pradeep B. Prevalence of risk factors for uterine fibroids at tertiary care teaching hospital: a cross-sectional study. Journal of Young Pharmacists. 2020;12(1):86.
Rodríguez J, Isern J, Pons N, Carmona A, Vallejo E, Cassadó J, De Marcos JA, Paraira M, Giménez N, Pessarrodona A. Pregnancy outcomes after ultrasound- guided high-intensity focused ultrasound (USgHIFU) for conservative treatment of uterine fibroids: experience of a single institution. International Journal of Hyperthermia. 2021 Sep 10;38(2):9-17.
Coutinho LM, Assis WA, Spagnuolo-Souza A, Reis FM. Uterine Fibroids and Pregnancy: How Do They Affect Each Other? Reprod Sci. 2022;29(8):2145-51.
Bula Ibula D, Balestra A, Tanos P, Nisolle M, Karampelas S. Uterine Artery Embolization Before Myomectomy: Is It Worth the Trouble? J Minim Invasive Gynecol. 2025;32(4):386-94.
Yang Q, Al-Hendy A. Update on the Role and Regulatory Mechanism of Extracellular Matrix in the Pathogenesis of Uterine Fibroids. Int J Mol Sci. 2023;24(6).
Lee IT, Berger DS, Koelper N, Senapati S, Mainigi M. Race, ovarian responsiveness, and live birth after in vitro fertilization. Fertil Steril. 2023;120(5):1023-32.
Suzuki T, Dai Y, Ono M, Kojima J, Sasaki T, Fujiwara H, et al. Pivotal Role of Ubiquitin Carboxyl-Terminal Hydrolase L1 (UCHL1) in Uterine Leiomyoma. Biomolecules. 2023;13(2).
Busnelli A, Barbaro G, Pozzati F, D'Ippolito S, Cristodoro M, Nobili E, et al. The importance of the 'uterine factor' in recurrent pregnancy loss: a retrospective cohort study on women screened through 3D transvaginal ultrasound. Hum Reprod. 2024;39(8):1645-55.
Ezike O, Schneyer R, Wright K, Hamilton K. Impact of fibroids on fertility, pregnancy loss, and preconception management. Curr Opin Obstet Gynecol. 2025;37(4):207-14.
Al-Hendy A, Segars JH, Taylor HS, González F, Siblini H, Zamah M, et al. Fibroids and unexplained infertility treatment with epigallocatechin gallate: a natural compound in green tea (FRIEND) - protocol for a randomised placebo-controlled US multicentre clinical trial of EGCG to improve fertility in women with uterine fibroids. BMJ Open. 2024;14(1):e078989.
Al-Husban N, Odeh O, AlRamahi M, Qadri S, Al-Husban H. Fertility-enhancing hysteroscopic surgery; multi-center retrospective cohort study of reproductive outcome. BMC Womens Health. 2023;23(1):459.
Włodarczyk M, Nowicka G, Ciebiera M, Ali M, Yang Q, Al-Hendy A. Epigenetic Regulation in Uterine Fibroids-The Role of Ten-Eleven Translocation Enzymes and Their Potential Therapeutic Application. Int J Mol Sci. 2022;23(5).
Falahati Z, Mohseni-Dargah M, Mirfakhraie R. Emerging Roles of Long Non-coding RNAs in Uterine Leiomyoma Pathogenesis: a Review. Reprod Sci. 2022;29(4):1086-101.
Jiang Z, Li Q, Li W, Zhu X, Jiang J, Chen L, et al. A comparative analysis of pregnancy outcomes of patients with uterine fibroids after high intensity focused ultrasound ablation and laparoscopic myomectomy: a retrospective study. Int J Hyperthermia. 2021;38(1):79-84.
Kong X, Jin F, Tang G, Qin Y, Liu D, Sun J. Causality between neuroticism personality clusters and female reproductive diseases in European population: a two-sample bidirectional mendelian randomization study. BMC Womens Health. 2024;24(1):507.
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