A 34-year-old woman with a known 8 cm uterine fibroid presents at 18 weeks of pregnancy with acute onset of severe localized abdominal pain, low-grade fever, and tenderness over the uterine fundus. There is no vaginal bleeding. The most likely diagnosis is:
- A Torsion of the fibroid
- B Red degeneration of the fibroid ✓
- C Sarcomatous change in the fibroid
- D Placental abruption
Correct answer: B. Red degeneration of the fibroid
Explanation
Red degeneration is the most common degenerative change in fibroids during pregnancy, typically occurring in the second or third trimester. Rapid fibroid growth outpaces its blood supply, causing hemorrhagic infarction. The presentation of acute localized pain, low-grade fever, and focal tenderness without bleeding is classic. Sarcomatous change is rare, presents with rapid enlargement, and is not associated with acute pain and fever in this pattern.
Reference: High Risk Pregnancy: Management Options, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.