Prevalence and Sonographic Patterns of Uterine Fibroid Among Women of Reproductive Age in Jos, Plateau State, Nigeria
Authors: Ukaonu Chigoze Blessed , Ibinaiye Philip O , Owoeye Sunday Cornelius , Birma Meshack Rufus , Angbalaga Alex , Ogbu Abraham Ekma 
Published: March 2023

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 tumor among Nigerian women of reproductive age living in Jos, Plateau State.

Materials and Methods:
It was a prospective cross-sectional hospital-based study, in which 295 women of the age between 20 years and 50 years were recruited randomly after obtaining informed consent from each woman. Abdominopelvic ultrasound scan was performed on each participant using a GE Logic 5 machine fitted with 3.5-MHz probe with emphasis on the location, number, and characterization of uterine leiomyoma(s); thereafter, transvaginal ultrasound scan using 7.5-MHz 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 tumor postsurgery 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 the Social Sciences version 20 (SPSS20). The results were presented in the form of tables and charts.

Results:
The mean age for the participants was 32.66 ± 7.66 years ranging from 21 to 50 years, and the mean age of the sonographically confirmed fibroid cases was 34.99 ± 6.79 years with a range of 21–48 years. This 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 ± 69.24 cm3, 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 postmyomectomy for those that had surgery in the course of the study showed cellular leiomyoma to be the most common (95.23%) type; there was 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.