2. • MIOMAS, FIBROMAS, FIBROMIOMAS.
• Tumores de color blanco o rosa pálido
compuestos por musculo liso con
cantidades de tejido conjuntivo fibroso.
• 95% surge en el cuerpo uterino
• 5% en el cérvix
• Raramente en trompas de Falopio o
ligamento redondo.
3. • Representan el 10% de los
problemas ginecológicos.
• Mayor incidencia en la
menopausia (50 años).
• Miomas crecen como respuesta al
estrógeno por tanto el crecimiento
es mas intenso durante el
embarazo.
4. Submucosos: Se encuentran
debajo del endometrio y
tienden a comprimirlo a
medida que crecen hacia
la cavidad uterina, son los
más propensos a producir
hemorragias profusas.
Intramurales: Se sitúan en la
musculatura uterina
(miometrio). Si son múltiples
y de gran tamaño
aumentan en forma
considerable el volumen
uterino.
SUBSEROSOS: Se hallan en la
superficie serosa del útero y
pueden protruir hacia la
cavidad peritoneal, tienden a
ser pediculados y semejar
neoplasia ovárica pueden
extenderse entre las dos capas
peritoneales del ligamento
ancho, volviéndose miomas
intraligamentarios.
Otras presentaciones son
vaginal y ovárica. Los
miomas pueden ser únicos o
múltiples y abarcar toda la
extensión del útero
5. SUBPERITONEAL
SUBMUCOSO
El crecimiento ocurre cuando aun
desarrollándose el mioma de la
capa muscular, lo hace en un
punto muy aproximo a la superficie
peritoneal.
SUBSEROSO
El mioma crece levantando el
peritoneo y haciendo
prominencia en la cavidad
peritoneal en forma polipoidea.
El mioma crece en forma
central, deformando a la vez la
superficie intracavitaria del útero
y la superficie peritoneal.
INTRAMURAL
6.
7. TAMAÑO: oscila desde el de un
grano de mijo a 30 o mas cm de
diámetro. Puede crecer hasta
alcanzar mas de los 45 kg.
Tienen pocos vasos sanguíneos
por lo que son mal irrigados.
Mioma telangiectoide mioma
don dilatación de vasos
sanguíneos
Puede ser único o
múltiple, siempre
esta formado por
nódulos esféricos.
11. • 3.9 % delos embarazos
• Primigestas después de los 30 años o
mujeres sin hijos.
• Pueden existir complicaciones durante
cualquier etapa de la gestación en un
10%
12. • Peligro para el feto
• Afectando la circulación
causando un aborto, parto
prematuro, presentación
anormal. Falta de
encajamiento, distocia,
hemorragia puerperal,
roturas de membranas,
crecimiento intrauterino
retardado,
desprendimiento de
placenta y placenta
previa.
13. Cesárea en caso de la
existencia de un mioma
voluminoso
interponiéndose como un
tumor previo.
Uso de tocolíticos y Trabajo
de parto prematuro.
MAYORES
COMPLICACIONES
• Mioma aparezca en la
fase de alumbramiento
14. La degeneración mas característica es la
necrobiosis aséptica sobre todo en los
que el volumen supera los 200cm³
apareciendo en el transcurso del 2
trimestre o a principios del 3.
16. •Sirven para clarificar la naturaleza de la
masa pélvica y permiten, con una
seguridad del 80%, el diagnóstico
diferencial de una gestación, masa
ovárica, o mioma subseroso sólido.
Ultrasonidos:
•Es más exacta para predecir las
características histológicas de un tumor.
Es útil para la investigación o en casos de
dificultades diagnósticas, por su alto nivel
de exactitud, pero no es necesaria en el
manejo rutinario de los miomas.
Resonancia
nuclear
magnética:
• miomas de no más de 2 a 3 pulgadas
de tamaño, nos facilitará la posibilidad
de extirpar pequeños miomas.
Laparoscopía:
17. • Depende de diversas variables
como: numero, tamaño,
localización, cuadro clínico,
edad y la posibilidad de la
malignidad.
18. •Reducir o abolir la pérdida
menstrual en paciente con
menorragia.D isminución del
20% del volumen del mioma
uterino.
Esteroides
andrógenos
(danazol y
gestrinona):
•se pueden usar en el alivio
del dolor pélvico de mujeres
incluyendo el dolor de la
degeneración del mismo.
Inhibidores de la
síntesis de
prostaglandinas
(PG)
21. Cuidados Preoperatorios: Cuidados en el día de la Operación:
Verificar que los
exámenes de laboratorio
estén completos
Brindar apoyo
emocional.
Control de funciones
vitales.
Desde la mañana hasta la
tarde mantener con dieta
Liquida.
vendaje de los miembros
inferiores
Acompañarlo a la sala de
operación
colocar dos enemas
evacuantes (8 – 10 pm) y a
las (6 am) para evacuar
todo contenido gástrico en
los intestinos.
Prepara la zona que va
hacer intervenida: baño,
recorte de bello pubiana
Retirar todo tipo de prótesis
y verificar que las uñas no
estén pintadas, para
observar si entra a un
cuadro de hipoxia.
22. Cuidados Post Operatorios:
Monitorizar las funciones vitales. primer día brindar dieta liquida, el
segundo dieta blanda y después dieta
completa.
Observar los apósitos de la herida
operatoria.
curación de la herida operatoria.
Realizar palpación a nivel del
abdomen para verificar si esta
distendido por presencia de gases.
movilización al paciente e incluso a la
de ambulación
prevenir y evitar las hemorragias, el
estreñimiento y ayudar a expandir los
pulmones a realizando globos y
ejercicios respiratorios.
Vigilar las evacuaciones intestinales
(diuresis y deposiciones)
23. • A.José,Nuñez Clavero, Tratado de Ginecología, Ed. Díaz
de Santos, 14ª Edición.
• Pernoll L. Martin, Benson.Pernoll, Manual de Obstetricia
y Ginecología, Ed. Graw Hill, 10ª Edición.
• http://clubensayos.com/Ciencia/Cuidados-Enfermeria-
Miomatosis/5064.html
Hinweis der Redaktion
Animated picture list with color text tabs(Intermediate)To reproduce the SmartArt effects on this page, do the following:On the Home tab, in the Slides group, click Layout, and then clickBlank. On the Insert tab, in the Illustrations group, click SmartArt.In the Choose a SmartArt Graphic dialog box, in the left pane, click List. In the List pane, double-click Horizontal Picture List (fifth row, second option from the left) to insert the graphic into the slide. Press and hold CTRL, and select the picture placeholder and text shape (top and bottom shape) in one of the objects. Under SmartArt Tools,on the Design tab, in the Create Graphic group, click Add Shape, and then click Add Shape After. Repeat this process one more time for a total of five picture placeholders and text shapes. Select the graphic. Under SmartArt Tools, on the Format tab, click Size, and then do the following:In the Height box, enter 4.44”.In the Width box, enter 9.25”.Under SmartArt Tools, on the Format tab, click Arrange, click Align, and then do the following:Click Align to Slide.Click Align Middle. Click Align Center. Select the graphic, and then click one of the arrows on the left border. In the Type your text here dialog box, enter text.Press and hold CTRL, and then select all five text boxes in the graphic. On the Home tab, in the Font group, select Corbel from the Font list,and then enter 22 in the Font Size box.Select the graphic. Under SmartArtTools, on the Design tab, in the SmartArtStyles group, do the following: Click ChangeColors, and then under Colorful click Colorful Range – Accent Colors 2 to 3 (second option from the left).Click More, and then under Best Match for Document click Moderate Effect (fourth option from the left).Select the rounded rectangle at the top of the graphic. Under SmartArtTools, on the Format tab, in the ShapeStyles group, click the arrow next to ShapeFill, and then under Theme Colors clickWhite, Background 1, Darker 35% (fifth row, first option from the left).Click each of the five picture placeholders in the SmartArt graphic, select a picture, and then click Insert.To reproduce the animation effects on this slide, do the following:On the Animations tab, in the Advanced Animations group, click Animation Pane.On the slide, select the graphic. On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and under Entrance, click Float In.In the Animation group, click Effect Options, and under Sequence, click One by One. In the Timing group, in the Duration list, click 01.00.In the Animation Pane, click the double-arrow below the animation effect to expand the list of effects, then do the following to modify the list of effects:Select the first animation effect, and then do the following:On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and then click More Entrance Effects. In the Change Entrance Effects dialog box, under Moderate, click Basic Zoom.Click Effect Options, and under Zoom, click Out Slightly. In the Timing group, in the Start list, select With Previous.Also in the Timing group, in the Duration list, click 01.00.Press and hold CTRL, select the third, fifth, seventh, ninth, and 11th animation effects (effects for the text shapes), and then do the following:On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and then click More Entrance Effects. In the Change Entrance Effects dialog box, under Basic, click Peek In, and then click OK. In the Animation group, click Effect Options, and underDirection, click From Top.In the Timing group, in the Duration list, click 01.00.Press and hold CTRL, select the second, fourth, sixth, eighth, and 10th animation effects (effects for the pictures). In the Timing group, in the Start list, selectAfter Previous.To reproduce the background effects on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then click Linear Down (first row, second option from the left).Under Gradient stops, click Add gradient stop or Remove gradient stop until two stops appear on the slider, then customize the gradient stops as follows:Select the first stop in the slider, and then do the following:In the Position box, enter 0%.Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 130, Green: 126, and Blue: 102.Select the last stop on the slider, and then do the following: In the Position box, enter 71%.Click the button next to Color, and then click Black, Text 1(first row, second option from the left).
Animated picture list with color text tabs(Intermediate)To reproduce the SmartArt effects on this page, do the following:On the Home tab, in the Slides group, click Layout, and then clickBlank. On the Insert tab, in the Illustrations group, click SmartArt.In the Choose a SmartArt Graphic dialog box, in the left pane, click List. In the List pane, double-click Horizontal Picture List (fifth row, second option from the left) to insert the graphic into the slide. Press and hold CTRL, and select the picture placeholder and text shape (top and bottom shape) in one of the objects. Under SmartArt Tools,on the Design tab, in the Create Graphic group, click Add Shape, and then click Add Shape After. Repeat this process one more time for a total of five picture placeholders and text shapes. Select the graphic. Under SmartArt Tools, on the Format tab, click Size, and then do the following:In the Height box, enter 4.44”.In the Width box, enter 9.25”.Under SmartArt Tools, on the Format tab, click Arrange, click Align, and then do the following:Click Align to Slide.Click Align Middle. Click Align Center. Select the graphic, and then click one of the arrows on the left border. In the Type your text here dialog box, enter text.Press and hold CTRL, and then select all five text boxes in the graphic. On the Home tab, in the Font group, select Corbel from the Font list,and then enter 22 in the Font Size box.Select the graphic. Under SmartArtTools, on the Design tab, in the SmartArtStyles group, do the following: Click ChangeColors, and then under Colorful click Colorful Range – Accent Colors 2 to 3 (second option from the left).Click More, and then under Best Match for Document click Moderate Effect (fourth option from the left).Select the rounded rectangle at the top of the graphic. Under SmartArtTools, on the Format tab, in the ShapeStyles group, click the arrow next to ShapeFill, and then under Theme Colors clickWhite, Background 1, Darker 35% (fifth row, first option from the left).Click each of the five picture placeholders in the SmartArt graphic, select a picture, and then click Insert.To reproduce the animation effects on this slide, do the following:On the Animations tab, in the Advanced Animations group, click Animation Pane.On the slide, select the graphic. On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and under Entrance, click Float In.In the Animation group, click Effect Options, and under Sequence, click One by One. In the Timing group, in the Duration list, click 01.00.In the Animation Pane, click the double-arrow below the animation effect to expand the list of effects, then do the following to modify the list of effects:Select the first animation effect, and then do the following:On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and then click More Entrance Effects. In the Change Entrance Effects dialog box, under Moderate, click Basic Zoom.Click Effect Options, and under Zoom, click Out Slightly. In the Timing group, in the Start list, select With Previous.Also in the Timing group, in the Duration list, click 01.00.Press and hold CTRL, select the third, fifth, seventh, ninth, and 11th animation effects (effects for the text shapes), and then do the following:On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and then click More Entrance Effects. In the Change Entrance Effects dialog box, under Basic, click Peek In, and then click OK. In the Animation group, click Effect Options, and underDirection, click From Top.In the Timing group, in the Duration list, click 01.00.Press and hold CTRL, select the second, fourth, sixth, eighth, and 10th animation effects (effects for the pictures). In the Timing group, in the Start list, selectAfter Previous.To reproduce the background effects on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then click Linear Down (first row, second option from the left).Under Gradient stops, click Add gradient stop or Remove gradient stop until two stops appear on the slider, then customize the gradient stops as follows:Select the first stop in the slider, and then do the following:In the Position box, enter 0%.Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 130, Green: 126, and Blue: 102.Select the last stop on the slider, and then do the following: In the Position box, enter 71%.Click the button next to Color, and then click Black, Text 1(first row, second option from the left).
Animated picture list with color text tabs(Intermediate)To reproduce the SmartArt effects on this page, do the following:On the Home tab, in the Slides group, click Layout, and then clickBlank. On the Insert tab, in the Illustrations group, click SmartArt.In the Choose a SmartArt Graphic dialog box, in the left pane, click List. In the List pane, double-click Horizontal Picture List (fifth row, second option from the left) to insert the graphic into the slide. Press and hold CTRL, and select the picture placeholder and text shape (top and bottom shape) in one of the objects. Under SmartArt Tools,on the Design tab, in the Create Graphic group, click Add Shape, and then click Add Shape After. Repeat this process one more time for a total of five picture placeholders and text shapes. Select the graphic. Under SmartArt Tools, on the Format tab, click Size, and then do the following:In the Height box, enter 4.44”.In the Width box, enter 9.25”.Under SmartArt Tools, on the Format tab, click Arrange, click Align, and then do the following:Click Align to Slide.Click Align Middle. Click Align Center. Select the graphic, and then click one of the arrows on the left border. In the Type your text here dialog box, enter text.Press and hold CTRL, and then select all five text boxes in the graphic. On the Home tab, in the Font group, select Corbel from the Font list,and then enter 22 in the Font Size box.Select the graphic. Under SmartArtTools, on the Design tab, in the SmartArtStyles group, do the following: Click ChangeColors, and then under Colorful click Colorful Range – Accent Colors 2 to 3 (second option from the left).Click More, and then under Best Match for Document click Moderate Effect (fourth option from the left).Select the rounded rectangle at the top of the graphic. Under SmartArtTools, on the Format tab, in the ShapeStyles group, click the arrow next to ShapeFill, and then under Theme Colors clickWhite, Background 1, Darker 35% (fifth row, first option from the left).Click each of the five picture placeholders in the SmartArt graphic, select a picture, and then click Insert.To reproduce the animation effects on this slide, do the following:On the Animations tab, in the Advanced Animations group, click Animation Pane.On the slide, select the graphic. On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and under Entrance, click Float In.In the Animation group, click Effect Options, and under Sequence, click One by One. In the Timing group, in the Duration list, click 01.00.In the Animation Pane, click the double-arrow below the animation effect to expand the list of effects, then do the following to modify the list of effects:Select the first animation effect, and then do the following:On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and then click More Entrance Effects. In the Change Entrance Effects dialog box, under Moderate, click Basic Zoom.Click Effect Options, and under Zoom, click Out Slightly. In the Timing group, in the Start list, select With Previous.Also in the Timing group, in the Duration list, click 01.00.Press and hold CTRL, select the third, fifth, seventh, ninth, and 11th animation effects (effects for the text shapes), and then do the following:On the Animations tab, in the Animation group, click the More arrow at the Effects Gallery and then click More Entrance Effects. In the Change Entrance Effects dialog box, under Basic, click Peek In, and then click OK. In the Animation group, click Effect Options, and underDirection, click From Top.In the Timing group, in the Duration list, click 01.00.Press and hold CTRL, select the second, fourth, sixth, eighth, and 10th animation effects (effects for the pictures). In the Timing group, in the Start list, selectAfter Previous.To reproduce the background effects on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then click Linear Down (first row, second option from the left).Under Gradient stops, click Add gradient stop or Remove gradient stop until two stops appear on the slider, then customize the gradient stops as follows:Select the first stop in the slider, and then do the following:In the Position box, enter 0%.Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 130, Green: 126, and Blue: 102.Select the last stop on the slider, and then do the following: In the Position box, enter 71%.Click the button next to Color, and then click Black, Text 1(first row, second option from the left).