🤔Episode 7: Myomectomy Explained 

A myomectomy is a surgical procedure to remove fibroids while preserving the uterus.

Unlike a hysterectomy, the uterus is left intact, making myomectomy an important option for women who wish to have children in the future or prefer to keep their uterus.

🧐Who may benefit from a myomectomy?

Myomectomy may be recommended for women with:

🔴 Heavy menstrual bleeding caused by fibroids.

🔴 Fibroids affecting fertility or causing recurrent miscarriage.

🔴 Significant pelvic pain or pressure.

🔴 Large or rapidly growing fibroids causing symptoms.

🔴 Fibroids that distort the uterine cavity.

💥Types of Myomectomy

🎯Hysteroscopic Myomectomy

Performed through the cervix without abdominal incisions.

✔ Best for submucous fibroids inside the uterine cavity.

🎯Laparoscopic Myomectomy

Performed through small abdominal incisions using a camera.

✔ Suitable for selected women with a limited number and size of fibroids.

🎯Open Myomectomy (Laparotomy)

Performed through an abdominal incision.

✔ Often recommended for multiple, very large, or deeply embedded fibroids.

🧠Benefits

✅ Preserves the uterus

✅ Improves symptoms

✅ May improve fertility in appropriately selected women.

✅ Improves quality of life.

🧐Things to Remember

• Fibroids can recur after myomectomy.

• Not every fibroid requires surgery.

• The surgical approach depends on the number, size, and location of the fibroids, as well as the surgeon's expertise.

👁Key Message

Myomectomy removes the fibroids not the uterus.

The best surgical approach is individualized and should be chosen after careful evaluation and discussion with your gynecologist.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab

 #Myomectomy #Fibroids #UterineFibroids #WomensHealth #Gynecology #Fertility #PregnancyCare #MinimallyInvasiveSurgery

 🧐Episode 6: When Should Fibroids Be Removed?

One of the biggest misconceptions is that every fibroid needs surgery.

The truth is: most fibroids do not require removal unless they are causing problems.

The decision to remove a fibroid is based on symptoms, location, size, fertility plans, and its impact on quality of life not simply its presence.

💥Fibroid removal may be recommended when:

🔴 Heavy menstrual bleeding

Persistent heavy periods

Iron deficiency anemia

Bleeding that affects daily activities.

🔴 Infertility or recurrent miscarriage

Especially with submucous fibroids

Intramural fibroids that distort the uterine cavity.

🔴 Significant pelvic pain or pressure

Chronic pelvic pain

Pelvic heaviness

Pain affecting daily life.

🔴 Pressure on nearby organs

Frequent urination

Difficulty emptying the bladder

Constipation or rectal pressure.

🔴 Rapidly enlarging fibroid

Particularly when associated with symptoms

Requires careful evaluation.

🔴 Very large fibroids

Causing marked abdominal enlargement

Significant pressure symptoms

Distortion of pelvic anatomy.

🎯Surgery is NOT always necessary if:

🟢 The fibroid causes no symptoms

🟢 Fertility is not affected

🟢 Pregnancy is progressing normally

🟢 The fibroid is stable on follow-up.

🧐Key Message

The presence of a fibroid alone is not an indication for surgery.

Treatment should always be individualized, taking into account the woman's symptoms, reproductive goals, and the characteristics of the fibroid.

The goal is to treat the patient not just the ultrasound report.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab

 #UterineFibroids  #Gynecology #FibroidSurgery #Myomectomy #FertilityAwareness

 🤰Episode 5: Fibroids and Pregnancy

Many women are surprised to learn they have fibroids during pregnancy.

The good news is that most women with fibroids have successful pregnancies and healthy babies.

However, the impact of fibroids during pregnancy depends largely on their size, number, and location.

💥Submucous Fibroids

🔴 Most likely to interfere with pregnancy

These fibroids distort the uterine cavity and may be associated with: 

• Difficulty conceiving

• Increased risk of miscarriage

• Problems with implantation.

💥Intramural Fibroids

🟡 May affect pregnancy

Large intramural fibroids can sometimes be associated with: 

• Miscarriage 

• Pain due to fibroid degeneration 

• Preterm labor 

• Malpresentation of the baby 

• Increased likelihood of cesarean delivery.

💥subserosal Fibroids

🟢 Usually have the least impact on pregnancy.

Because they grow on the outer surface of the uterus, they generally do not interfere with fetal growth or implantation.

However, very large fibroids may occasionally cause discomfort or pressure symptoms.

🧠What Happens to Fibroids During Pregnancy?

Fibroids may increase in size, particularly during the first and second trimesters, due to hormonal changes.

🤰Some women may experience:

• Abdominal pain 

• Localized tenderness 

• Red degeneration of the fibroid.

Fortunately, many fibroids remain stable and cause no significant complications.

🤔Key Message

Having fibroids does not mean you cannot have a healthy pregnancy.

Most women with fibroids deliver healthy babies, but careful antenatal monitoring is important, especially when fibroids are large, multiple, or close to the uterine cavity.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab  

#Fibroids 

#Pregnancy 

#PregnancyCare 

#UterineFibroids 

#WomensHealth  #HealthyPregnancy

 Episode 4: Fibroids and Infertility

One of the most common questions women ask after being diagnosed with fibroids is:

"Can fibroids prevent me from getting pregnant?"

The answer is not always straightforward.

Many women with fibroids conceive naturally and have healthy pregnancies. 

However, the impact of fibroids on fertility depends largely on their location within the uterus.

💥Submucous Fibroids

🔴 Most likely to affect fertility

Submucous fibroids grow beneath the lining of the uterine cavity and distort its shape.

They may:

 • Interfere with embryo implantation

• Increase the risk of miscarriage

• Reduce pregnancy rates

Even relatively small submucous fibroids can have a significant effect on fertility.

💥Intramural Fibroids

🟡 May affect fertility

Intramural fibroids develop within the muscular wall of the uterus.

Small intramural fibroids usually have little or no impact on fertility.

However, larger fibroids especially those that distort the uterine cavitymay:

 • Reduce implantation rates

• Lower IVF success rates

• Increase miscarriage risk

The relationship is more complex and often depends on size and proximity to the uterine cavity.

💥Subserosal Fibroids

🟢 Least likely to affect fertility

Subserosal fibroids grow on the outer surface of the uterus.

Because they do not usually distort the uterine cavity, they generally have little or no effect on:

 • Conception

• Implantation

• Pregnancy rates

They are more likely to cause pressure symptoms than fertility problems.

🧐Key Message

When assessing fertility in a woman with fibroids, location is often more important than size.

A small submucous fibroid may have a greater impact on fertility than a much larger subserosal fibroid.

Understanding the type of fibroid helps guide both fertility counseling and treatment decisions.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab  #Fibroids #Infertility #FertilityAwareness #UterineFibroids #WomensHealth #Gynecology #IVF #PregnancyCare

 Happy Father's Day 💙

Behind every healthy pregnancy and every growing family, there is often a supportive father walking the journey alongside them.

Thank you to all fathers who provide love, encouragement, and care during pregnancy, childbirth, and beyond.

Your support matters more than you know.

#DrRababCares 

#FathersDay

 #PregnancySupport 

#FamilyCare

 🎯Episode 3: Fibroids and Heavy Bleeding

One of the most common reasons women with fibroids seek medical attention is heavy menstrual bleeding.

However, not all fibroids affect menstrual bleeding in the same way.

The impact largely depends on the location of the fibroid within the uterus.

🤔Submucous Fibroids

These fibroids develop just beneath the lining of the uterine cavity and are the type most strongly associated with heavy menstrual bleeding.

Even relatively small submucous fibroids can cause: 

• Heavy periods

• Prolonged bleeding

• Passage of blood clots

• Iron deficiency anemia.

This is because they distort the uterine cavity and increase the surface area of the endometrium.

🤔Intramural Fibroids

Intramural fibroids grow within the muscular wall of the uterus.

When they become large or extend toward the uterine cavity, they may contribute to:

 • Heavy menstrual bleeding

• Prolonged periods

• Pelvic pressure.

The effect is generally less pronounced than with submucous fibroids but can still be clinically significant.

🤔Subserosal Fibroids

Subserosal fibroids grow on the outer surface of the uterus.

These fibroids are least likely to cause heavy menstrual bleeding because they do not directly affect the uterine cavity or its lining.

Instead, they are more commonly associated with: 

• Pelvic pressure

• Abdominal fullness

• Urinary or bowel symptoms due to pressure on nearby organs.

💥Key Message

When a woman with fibroids presents with heavy menstrual bleeding, the first question is not "How big is the fibroid?" but rather "Where is the fibroid located?"

The location of a fibroid often has a greater impact on bleeding symptoms than its size alone.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab

 #Fibroids 

#HeavyMenstrualBleeding 

#UterineFibroids #Gynecology #WomensHealth #FertilityAwareness

 Fibroids Explained

Episode 2: Types of Fibroids

Not all fibroids are the same.

The symptoms, impact on fertility, and treatment options often depend on where the fibroid is located within the uterus.

There are three main types of fibroids:

1. Intramural Fibroids

These develop within the muscular wall of the uterus and are the most common type.

2. Submucous Fibroids

These grow beneath the lining of the uterine cavity and may significantly affect menstrual bleeding and fertility.

3. Subserosal Fibroids

These grow on the outer surface of the uterus and may cause pressure symptoms depending on their size.

🤔Understanding the type of fibroid is often more important than simply knowing its size.

In the next episodes, we will explore each type in detail and discuss how it may affect symptoms, fertility, and pregnancy.

Dr Rabab Cares 

#DrRababCares 

#FibroidsExplainedByDrRabab 

#Fibroids 

#UterineFibroids 

#WomensHealth 

 #FertilityAwareness

 "You have fibroids."

Few words can cause so much anxiety.

Do fibroids cause infertility? 

Will I need surgery? 

Can I still get pregnant? 

Are all fibroids dangerous?

The truth is that not all fibroids are the same, and not every fibroid requires treatment.

In this series, we will answer the most common questions about fibroids and separate facts from myths.

Welcome to Fibroids Explained.

Dr Rabab Cares 

#DrRababCares

#Fibroids

#WomensHealth

#Fertility

#Pregnancy

#HeavyPeriods

#PelvicPain

#FibroidsExplainedByDrRabab

 🔑 Key Message

Throughout this series on Müllerian

Not every suspected anomaly is a true anomaly.

An arcuate uterus,

 a septate uterus, 

a bicornuate uterus, 

a unicornuate uterus, 

and uterus didelphys 

may appear similar at first glance, yet they can have very different reproductive implications and management strategies.

This is why accurate diagnosis matters.

Careful assessment, appropriate imaging, clinical correlation, and follow-up are often just as important as the initial scan itself.

As clinicians, our responsibility is not to make the most dramatic diagnosis.

Our responsibility is to make the most accurate one.

Because the correct diagnosis guides the correct counseling, the correct management, and ultimately the best possible outcome for our patients.

Thank you for following this educational journey through Müllerian anomalies.

Dr Rabab Cares 

#DrRababCares 

#MullerianAnomalies 

#WomensHealth 

 #3DUltrasound 

#ReproductiveMedicine 

#FertilityEducation

 🩺 Uterus Didelphys

Uterus didelphys is a rare congenital Müllerian anomaly resulting from complete failure of fusion of the Müllerian ducts during fetal development.

As a result, a woman may have:

• Two separate uterine cavities

• Two cervices

• Sometimes a longitudinal vaginal septum.

Unlike a bicornuate uterus, where there is partial fusion, uterus didelphys results in two distinct uterine structures.

Can women with uterus didelphys become pregnant?

Absolutely.

Many women conceive naturally and may remain unaware of the condition until pregnancy or imaging studies reveal it.

However, uterus didelphys has been associated with an increased risk of:

• Miscarriage

• Preterm birth

• Malpresentation (especially breech presentation)

• Cesarean delivery.

One important consideration is the possible association with:

🩺 OHVIRA Syndrome (Obstructed Hemivagina and Ipsilateral Renal Anomaly)

Patients may present with:

 • Severe dysmenorrhea

• Chronic pelvic pain

• Hematocolpos

• Renal tract anomalies

Accurate diagnosis is essential.

3D ultrasound and MRI can help differentiate uterus didelphys from other Müllerian anomalies and identify associated abnormalities.

The key message:

Having two uteri does not mean a woman cannot have a successful pregnancy.

With appropriate diagnosis and obstetric care, many women achieve excellent reproductive outcomes.

Dr Rabab Cares 

#DrRababCares 

#UterusDidelphys

#MullerianAnomalies

#UterineAnomalies

#OHVIRASyndrome

#3DUltrasound

#HighRiskPregnancy

 🩺 Rudimentary Horn

A rudimentary horn is an underdeveloped uterine structure that may be present in women with a unicornuate uterus.

It can be:

 • Communicating 

• Non-communicating 

• Functional 

• Non-functional

Why is it important?

A non-communicating functional rudimentary horn may lead to:

• Severe dysmenorrhea 

• Chronic pelvic pain

 • Hematometra

 • Endometriosis

However, the most serious complication is:

⚠️ Rudimentary Horn Pregnancy

Although rare, pregnancy can occur within a rudimentary horn through transperitoneal migration of sperm or a fertilized ovum.

Because the horn is unable to expand normally, rupture may occur during the second trimester, resulting in catastrophic intra-abdominal hemorrhage.

Early diagnosis is therefore critical.

Clinical suspicion should increase when ultrasound shows: 

• A gestational sac separate from the main uterine cavity

 • An asymmetric uterine appearance 

• Difficulty identifying continuity with the cervix

3D ultrasound and MRI may help confirm the diagnosis.

Management of rudimentary horn pregnancy is surgical removal due to the high risk of rupture.

The key message:

A rudimentary horn is not simply an anatomical curiosity.

Recognizing it early can be life-saving.

Dr Rabab Cares 

#DrRababCares 

#RudimentaryHorn #RudimentaryHornPregnancy #UnicornuateUterus #MullerianAnomalies #UterineAnomalies

 🩺 Unicornuate Uterus

A unicornuate uterus is a rare congenital Müllerian anomaly that develops when only one Müllerian duct forms normally.

As a result, the uterus is smaller than usual and typically has a single functional uterine horn.

In some women, a rudimentary horn may also be present.

Why does it matter?

Although many women with a unicornuate uterus can conceive naturally, this condition is associated with increased reproductive and obstetric risks, including:

• Early pregnancy loss

• Second-trimester pregnancy loss

• Preterm birth

• Malpresentation

• Fetal growth restriction

• Increased cesarean delivery rates

One important consideration is the presence of a rudimentary horn.

A non-communicating rudimentary horn may be associated with:

• Pelvic pain

• Endometriosis

• Rare but potentially dangerous rudimentary horn pregnancy

Accurate diagnosis is essential.

3D transvaginal ultrasound and MRI can help define uterine anatomy and identify associated anomalies.

Women with a unicornuate uterus may also have associated renal tract anomalies, making further evaluation appropriate in selected cases.

With proper surveillance and individualized obstetric care, many women achieve successful pregnancies and healthy outcomes.

Dr Rabab Cares 🌷

#DrRababCares 

#UnicornuateUterus #MullerianAnomalies #UterineAnomalies  #MaternalHealth #PregnancyCare #HighRiskPregnancy #ReproductiveMedicine #FertilityEducation #3DUltrasound

 🩺 Bicornuate Uterus

A bicornuate uterus is a congenital uterine anomaly resulting from incomplete fusion of the Müllerian ducts during fetal development.

It is characterized by a deep external fundal indentation, creating the appearance of a "heart-shaped" uterus with two uterine horns.

One of the most important clinical challenges is differentiating a bicornuate uterus from a septate uterus, as management differs significantly.

Accurate diagnosis often requires:

 • 3D transvaginal ultrasound

 • MRI in selected cases.

What does it mean for fertility and pregnancy?

The good news is that most women with a bicornuate uterus can conceive naturally.

However, studies have shown an increased risk of: 

• Miscarriage 

• Preterm birth 

• Malpresentation (especially breech presentation)

 • Cervical insufficiency in selected patients 

• Increased cesarean delivery rates.

Importantly, bicornuate uterus is more strongly associated with pregnancy-related complications than with infertility itself.

Management is usually focused on: 

✔️ Accurate diagnosis

 ✔️ Individualized pregnancy surveillance 

✔️ Appropriate obstetric care

A bicornuate uterus should not automatically be viewed as a barrier to motherhood.

With proper monitoring, many women achieve successful pregnancies and healthy outcomes.

Dr Rabab Cares 

#DrRababCares 

#BicornuateUterus 

#MullerianAnomalies

 #UterineAnomalies  

 #PregnancyCare #ReproductiveMedicine #FertilityEducation #3DUltrasound #HighRiskPregnancy