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Etiology, symptomatology, and diagnosis of uterine myomas

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1 Etiology, symptomatology, and diagnosis of uterine myomas
William H. Parker, M.D.  Fertility and Sterility  Volume 87, Issue 4, Pages (April 2007) DOI: /j.fertnstert Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

2 FIGURE 1 Population-based incidence of myomas relative to age for African-American and Caucasian women in the United States. (Reprinted from Day Baird D, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol 2003;188:100–7. Copyright 2003 Elsevier, Inc., with permission.) Parker. Uterine myomas. Fertil Steril 2007. Fertility and Sterility  , DOI: ( /j.fertnstert ) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

3 FIGURE 2 Cumulative incidence of hysterectomy for African-American, Caucasian, and Hispanic women. (Reprinted from Myers E, Barber M, Couchman G, Datta S, Gray R, Gustilo-Ashby T, et al. Management of uterine fibroids. Vol. 1. AHRQ Evidence Reports, no. 24. AHRQ publication no. 01-E052, July Available at: Reprinted with permission from the author.) Parker. Uterine myomas. Fertil Steril 2007. Fertility and Sterility  , DOI: ( /j.fertnstert ) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

4 FIGURE 3 The relative risks of increased fibroid development associated with age at delivery among 624 participants in the U.S. National Institute of Environmental Health Sciences Uterine Fibroid Study. (Reprinted from Baird DD, Dunson DB. Why is parity protective for uterine fibroids? Epidemiology 2003;14:247–50. Copyright 2003 Lippincott Williams & Wilkins, with permission.) Parker. Uterine myomas. Fertil Steril 2007. Fertility and Sterility  , DOI: ( /j.fertnstert ) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions

5 FIGURE 4 MR images of degenerating myoma and leiomyosarcoma. (A) Degenerating myoma shows no enhancement after gadolinium. (B) Leiomyosarcoma enhanced with Gd-DPTA at 60 seconds after administration. (C) Leiomyosarcoma enhanced with Gd-DPTA at 60 seconds after administration. (Reprinted from Goto A, Takeuchi S, Sugimura K, Maruo T. Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus. Int J Gynecol Cancer 2002;12:354–61. Copyright 2002 Blackwell Publishing, with permission.) Parker. Uterine myomas. Fertil Steril 2007. Fertility and Sterility  , DOI: ( /j.fertnstert ) Copyright © 2007 American Society for Reproductive Medicine Terms and Conditions


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