Red degeneration of fibroid
Red Degeneration of Fibroid
- Occurs mainly in large fibroids.
- Tumor is red/purple in color.
- It is due to thrombosis of large veins in the tumor.
- It has a peculiar fishy odor
- Occurs during Second half of pregnancy or puerperium.
- Most frequent complication of myoma during pregnancy.
- The tumor assumes a peculiar purple-red colour.
- Cause is vascular in nature (Thrombosis of large veins in the tumor).
- Infection has no role and the process is an aseptic one.
- Presentation as a case of an acute abdomen
- It produces pain and tenderness (hyaline degeneration does not)
- Clinical features include fever, moderate leucocytosis and increased ESR
- It has a peculiar fishy odor
MANAGEMENT:
- Patient is managed conservatively.
- Patient is put to bed rest and given analgesics (to relieve the pain), sedatives and if required antibiotics.
- Ru 486 (Mifepristone)
- GnRH analogues.
- If because of mistaken diagnosis iaparotomy is done, abdomen is closed without doing anything.
- Myomectomy should never be contemplated during caesarean section as vascularity of fibroid is increased during pregnancy (due to increased estrogen) leading to increased blood loss during cesarean section.
Exam Important
- Fibroid uterus with acute abdominal pain ,low grade fever and mild leucocytosis is suggestive of Red degeneration of fibroid .
- Red degeneration in uterine fibroid is most common in Second trimester
- Treatment of Red degeneration of fibroid during pregnancy include Analgesics
- Red degeneration of fibroid is due to Thrombosis of the veins
- Red degeneration of uterine fibroid Is aseptic infarcation
- Red degeneration of fibroid is associated with Pregnancy
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