Uterine Fibroid impact on women Health and quality of life -case paper presentation for gynec resident
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Uterine Fibroid Case Paper
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What's Inside the Case Paper
The document is structured as a professional gynaecology resident case presentation across 9 sections:
Structure at a Glance
| Section | Content |
|---|---|
| 1. Introduction & Epidemiology | Key statistics, incidence, racial disparities, aetiology & risk factors |
| 2. Illustrative Case | Mrs. S.K., 34F, P1L1 - complaints, HPI, menstrual/obstetric history, full examination findings |
| 3. Investigations | Haematology (Hb 7.2 g/dL), USS, MRI pelvis, endometrial biopsy, HSG |
| 4. FIGO / PALM-COEIN Classification | All 8 fibroid types with the case-specific types highlighted |
| 5. QoL Impact (multi-domain) | Physical health, reproductive/fertility, psychological, occupational/social; full UFS-QoL score profile |
| 6. Differential Diagnosis | Adenomyosis, endometrial carcinoma, ovarian mass, LMS, coagulopathy - each excluded with reasoning |
| 7. Management | Immediate (iron + tranexamic acid + GnRHa), medical options, surgical options, step-by-step plan for the case |
| 8. Evidence Summary | 9 key references with PMIDs including LIBERTY trials, FEMME RCT, Cochrane 2025, AAGL meta-analysis 2025 |
| 9. Learning Points + Discussion Questions | 10 take-home points; 5 discussion questions for the audience |
Key Evidence Cited
- Cochrane 2025 (PMID 40183418): GnRHa preoperatively raises Hb +0.88 g/dL, reduces operative time
- LIBERTY trials, AJOG 2023 (PMID 36370871): Relugolix combo - UFS-QoL improved by +37.6 vs +13.1 on placebo
- FEMME RCT 2022 (PMID 35435818): UAE vs myomectomy - similar 2-year QoL; UAE has higher reintervention rate
- AAGL SR, JMIG 2025 (PMID 39277104): RFA gives 65.4% fibroid volume reduction + UFS-QoL +53.4 points
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