A 30-year-old woman at 16 weeks gestation with known uterine fibroids presents with acute lower abdominal pain, low-grade fever, and localized uterine tenderness. Ultrasound shows a 6 cm intramural fibroid with heterogeneous echotexture. Which is the most likely diagnosis and appropriate initial management?
- A Fibroid torsion; urgent laparotomy and myomectomy
- B Sarcomatous change; urgent hysterectomy
- C Red degeneration; conservative management with analgesia ✓
- D Placental abruption; emergency caesarean section
Correct answer: C. Red degeneration; conservative management with analgesia
Explanation
Red degeneration of fibroids occurs in pregnancy due to hemorrhagic infarction from rapid growth outstripping its blood supply. It presents with acute pain, localized tenderness, and low-grade fever, typically in the second trimester. Management is conservative with rest, hydration, and analgesics. Surgery is avoided unless complications arise.
Reference: High-Risk Pregnancy: Management Options, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.