Abstract :
Introduction: Fibroid with heavy menstrual bleeding and pain in pre and perimenopause women to reduce
it, in reproductive women to relieve sympt oms in infertility and in preoperative conditions to reduce size
of fibroid, now a days medical therapy is available.
Aim: To determine effectiveness and safety of Ulipristal in symptomatic fibroid by assessing reduction in
heavy menstrual bleeding, pain, reduction in size of the fibroid and improvement in activity score
Materials and Methods: This is a Prospective study. Women between 20- 45years both unmarried and
married attending gynaec OPD of Saveetha Medical College and hospital with fibroid with symptoms of
heavy menstrual bleeding, pain abdomen during period, with Infertility were recruited after ethical Clarence
and informed consent. Study was conducted from September 2018 to Dec 2018 first week. Menstrual blood
loss was assessed with pictorial blood loss chart (PBAC) and pain was assessed with short form Mc Gill
pain questionnaire pain score. After routine investigation including LFT, USG abdomen and Pelvis were
done for all subject and mapping of fibroid were done pretreatment and every month and at the end of
treatment. Women were given10 mgs Ulipristal once daily for 13 weeks. Post treatment investigations and
USG were repeated.
Results: Women age group between 30-40 years were 86.5%, 20-25 were 6. 66% and Nulliparous were 6.
66%.Pretreatent 66.66% had PBAC score of 130 and above. None of the women had PBAC treatment. After 13 weeks treatment Perimenopause women 13.33 % developed amenorrhea. 20% women
had PBAC score < 100> 3.33% PABC score between 120 and above were Nil. Fibroid volume reduced between >25 to < 50> 53.33% of size and volume and 10% fibroid disappeared. There is considerable improvement in pain score
with p value of 0.0001 and activity score significantly improved with p value of 0.0001.
Conclusions: In all age groups commonest gynaec condition is Fibroid. In the study Ulipristal resulted
in, improvement in heavy men strual bleeding ,pain and considerable reduction in size of the fibroid and
thereby improved quality of life.
Keyword :
Medical management, Heavy menstrual blood loss, Quality of life, Pain score.