Abstract

Symptomatic uterine fibroids are managed by surgery. The medical management involves Tranexamic acid, OC pills, Progesterone, LNG IUS, GnRH analogues, as a temporary measure pre operatively. Selective Progesterone Receptor Modulators (SPRMs) are new group of drugs for the medical management. Ulipristal acetate is a SPRM, clinically approved drug in the management of fibroids.

The study was conducted at a tertiary care hospital in South India. Fifty women with fibroids and menorrhagia, awaiting definitive surgery or pre-operative to make them fit for surgery or wants medical treatment- are the subjects of the study. At the initiation of the treatment blood loss was quantified by PBAC scale. The number and volume of the fibroids were assessed by ultrasonography. Associated symptoms were recorded. Urlipristal acetate 5 mg daily was given for three months. Blood loss, amenorrhoea, and volume of fibroids was assessed at three months of treatment. Side effects were recorded. They were followed for further three months for resumption of menses.

The mean blood loss was reduced by 88 %.  Eighty two percent of women had amenorrhoea. There was 28.2 % of reduction in the volume of the fibroids. There were no troublesome side effects. Two amenorrhic women had hot flushes. 47 resumed menses in 30-40 days and the bleeding was normal or slightly less. There was relief from dysmenorrhoea and pressure symptoms of fibroids

The results of the study were compared with those of other studies. In terms of control of menorrhagia and reduction of fibroid size, 5 mg dose of ulipristalis equally efficacious as 10 mg dose.

Keywords: Symptomatic Fibroids; Menorrhagia; Ulipristal acetate; SPRMs.