A pregnant woman with fibroid uterus develops acute pain in abdomen with low grade fever and mild leucocytosis at 28 weeks ,the most likely diagnosis is: (A) Preterm labour, (B) Torsion of fibroid, (C) Red degeneration of fibroid, (D) Infection in fibroid
Answer is C. Red degeneration of fibroid: It results from softening of surrounding connective tissue The capillaries tend to rupture and blood effused out into the myoma causing a diffuse reddish discoloration The tumor it self assumes a peculiar purple red colour and develops a fishy odour,if the tumor is carefully examined We may find some vessels and large veins in the capsule thrombosed This is the most common complication with fibroid during pregnancy . And the patient is usually febrile and with moderate leucocytosis and raised ESR, the condition is aseptic one. And ultrasound is useful for diagnosis Ref Shaw 16/e pg 395