A 24-year-old primigravida at 20 weeks gestation presents with acute pain in a known uterine fibroid, low-grade fever, and mild leukocytosis. The uterus is tender over the fibroid. Fetal heart rate is normal. What is the most likely diagnosis?

• A Red degeneration of fibroid ✓
• B Torsion of the fibroid
• C Pyelonephritis
• D Abruptio placentae

Explanation

Red (carneous) degeneration of a fibroid occurs typically in the second trimester or puerperium due to venous thrombosis and haemorrhagic infarction within the tumour. It presents with acute localized pain, tenderness over the fibroid, low-grade fever and leukocytosis, and is managed conservatively with analgesia and hydration. Torsion applies to pedunculated subserosal fibroids, pyelonephritis produces urinary findings, and abruption causes fetal distress and vaginal bleeding.

Reference: Ian Donald's Practical Obstetric Problems, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.