A 26-year-old primigravida at 18 weeks gestation presents with acute lower abdominal pain, low grade fever, and a tender 10-week size fibroid uterus. Leucocyte count is mildly raised. The MOST likely diagnosis is:

• A Hyaline degeneration
• B Torsion of a pedunculated fibroid
• C Red degeneration (carneous change) ✓
• D Cystic degeneration

Explanation

Red degeneration occurs classically during pregnancy or with oral contraceptive use. The fibroid outgrows its blood supply, infarcts, and blood pigments leak into the tissue giving a raw beef-like cut surface. It presents with acute pain, localised tenderness, fever and mild leucocytosis, usually managed conservatively with analgesia. Hyaline degeneration is the commonest type but is asymptomatic. Torsion affects pedunculated subserosal fibroids, not an intramural mass.

Reference: DC Dutta's Textbook of Obstetrics, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.