Clinical Characteristics and Associated Factors of Uterine Fibroids based on the FIGO 2018 Classification at the National Hospital of Obstetrics and Gynecology, Vietnam
Nguyen Van Thang
Department of Gynecologic Oncology, National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam.
Nguyen Dieu Linh *
Department of Gynecologic Oncology, National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam.
*Author to whom correspondence should be addressed.
Abstract
Background: Uterine fibroids are common benign tumors in reproductive-age women, with clinical presentation varying by location as defined by the FIGO 2018 classification. Evidence from Vietnam remains limited regarding their clinical characteristics and associated factors.
Aims: to describe the clinical characteristics of uterine fibroids and to identify factors associated with fibroid classification according to the FIGO 2018 system among patients treated at the National Hospital of Obstetrics and Gynecology, Vietnam.
Study Design: A retrospective cross-sectional study
Place and Duration of Study: This study was conducted at the National Hospital of Obstetrics and Gynecology between 01/2023 and 12/2024.
Methodology: We collected data among 292 patients who underwent uterine-preserving surgery for uterine fibroids. Fibroids were classified according to the FIGO 2018 system and grouped into submucosal (types 0–2) and intramural/other fibroids (types 3–8). Descriptive statistics, Chi-square tests, and multivariable logistic regression analyses were performed to identify factors associated with fibroid type.
Results: Among 292 patients, the most common fibroid types according to the FIGO classification were type L5 (28.4%), followed by type L3 (21.9%) and type L4 (20.5%). Submucosal fibroids were more frequently detected within one month and were associated with a higher proportion of severe or very severe anemia compared with intramural or other fibroids. They were also more commonly associated with smaller uterine size and smaller fibroid size. Multivariable analysis showed that heavy menstrual bleeding (HMB) (OR = 2.36, 95% CI: 1.29–4.30), severe anemia (OR = 3.08, 95% CI: 1.14–8.33), and very severe anemia (OR = 4.91, 95% CI: 1.11–21.64) were significantly associated with submucosal fibroids, while tumors detected after more than 12 months, larger uterine size, and larger fibroid size were negatively associated with this subtype (p<0.05).
Conclusion: Fibroid location according to the FIGO 2018 classification is strongly associated with clinical characteristics of uterine fibroids. Submucosal fibroids are more likely to present with heavy menstrual bleeding and severe anemia and tend to be detected earlier, highlighting the importance of early evaluation and appropriate management in patients with abnormal uterine bleeding.
Keywords: Uterine fibroids, Leiomyoma, FIGO classification, abnormal uterine bleeding, heavy menstrual bleeding, anemia