Seeing red degeneration in uterine fibroids in pregnancy: proceed with caution

Background: Uterine leiomyomas are highly prevalent benign monoclonal tumors, arising from the smooth muscle of the myometrium; they occur in up to 50-60% of reproductive age women, causing significant morbidity in up to 30% of women. The most serious complication of uterine fibroids; is red degeneration that causes severe pain, and may lead to preterm labour, miscarriage, fetal and maternal morbidity and mortality. Objective of this study was designed to compare between the effect of vaginal natural MP and oral dydrogesterone in prevention of red degeneration of uterine fibroid during pregnancy.Methods: Patients were recruited from El-Shatby Maternity University Hospital. They were 50 pregnant females, diagnosed having a uterine fibroid more than 3 cm in size then there were divided into two groups, Group A: twenty-five treated by vaginal natural progesterone, Group B: twenty-five treated by oral dydrogesterone. All patients at 14-15 weeks of gestational age underwent complete history taking, clinical examination and ultrasound examination for mean gestational age and assessment of the type and uterine fibroid.Results: Results showed that there were no statistically significant differences as regards age, obstetric history (gravidity and parity), number, Site, grade and size of the fibroid. There was a significant difference between the two studied groups, regarding the acute abdominal pain, it occurred to only 3 cases (12%) in Group A, versus to 16 cases (64%) in Group B. Regarding occurrence of red degeneration, it occurred only to 3 cases (12%) in Group A, while in Group B it occurred to 15 cases (60%).Conclusions: Vaginal natural micronized progesterone is more effective than oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy with fewer complications. Vaginal natural progesterone daily dose of 200 mg is recommended to all pregnant females with uterine fibroids.

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Physiopathology and Management of Uterine Fibroids

10.5772/intechopen.94162 ◽

2020 ◽

Author(s):

Joel Noutakdie Tochie ◽

Therese Gaelle Badjand ◽

Gregory Ayissi ◽

Julius Sama Dohbit

Keyword(s):

Urinary Incontinence ◽

Pregnant Woman ◽

Menstrual Cycle ◽

Uterine Fibroid ◽

Uterine Fibroids ◽

Reproductive Age ◽

Heavy Menstrual Bleeding ◽

Spontaneous Abortions ◽

Red Degeneration ◽

In Pregnancy

Uterine fibroid is the most encountered benign tumour in women of reproductive age. It causes spontaneous abortions, missed abortions, painful red degeneration or infarction of the fibroids, abnormal foetal presentation, obstructed labour, and an increased likelihood of premature deliveries, caesarean deliveries, postpartum haemorrhage in pregnancy, whereas, in the non-pregnant women it is associated an irregular menstrual cycle sometimes associated with heavy menstrual bleeding, infertility, constipation, urinary incontinence, and leiosarcoma transformation. Till date is pathophysiology and management both in the non-pregnant and pregnant woman have not been well described. In this chapter, we present contemporary evidence to help elucidate this enigma.

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Color Doppler sonography of uterine fibroids in pregnancy as a predictor of growth

Ultrasound in Medicine & Biology ◽

10.1016/s0301-5629(03)00389-2 ◽

2003 ◽

Vol 29 (5) ◽

pp. S88

Author(s):

R.D. Harris ◽

C. Miao ◽

M. Beach ◽

D. Levine

Keyword(s):

Doppler Sonography ◽

Color Doppler ◽

Uterine Fibroids ◽

Color Doppler Sonography ◽

In Pregnancy

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Symptomatic uterine fibroids in pregnancy — wait or operate? Own experience

Ginekologia Polska ◽

10.5603/gp.2019.0058 ◽

2019 ◽

Vol 90 (6) ◽

pp. 320-324 ◽

Cited By ~ 2

Author(s):

Anna Fuchs ◽

Agnieszka Dulska ◽

Jerzy Sikora ◽

Iwona Czech ◽

Violetta Skrzypulec-Plinta ◽

...

Keyword(s):

Uterine Fibroids ◽

In Pregnancy

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HEALTHY AND PATHOLOGICAL CHANGES OF MYOMETRIUM: PREGNANT MYOMETRIUM, UTERINE FIBROIDS AND LEIOMYOSARCOMA. Cambios normales y patológicos del miometrio: miometrio del embarazo, fibrosis uterina y leiomiosarcoma

Revista Argentina de Anatomía Clínica ◽

10.31051/1852.8023.v4.n1.13945 ◽

2016 ◽

Vol 4 (1) ◽

pp. 7-13

Author(s):

Pasquapina Ciarmela ◽

Soriful Islam ◽

Pasquale Lamanna ◽

Andrea Tranquilli ◽

Mario Castellucci

Keyword(s):

Smooth Muscle ◽

Uterine Fibroids ◽

Present Review ◽

Benign Tumors ◽

Pathological Changes ◽

Uterine Smooth Muscle ◽

Smooth Muscle Tumors ◽

In Pregnancy

El miometrio, la pared muscular del útero, puede modificar su misma masa y las propiedades celulares en el embarazo y también en los tumores como el leiomioma y el leiomiosarcoma. El leiomioma, dicho también fibroma, es un tumor benigno del útero y se considera como una de las causas más frecuentes de infertilità en el período reproductivo femenino. El leiomiosarcoma, en cambio, es un tumor maligno y agresivo de la musculatura lisa uterina. La presente revisión discute las características generales del leiomioma y el leiomiosarcoma y los relativos tratamientos clínicos actualmente usados y además describe las características del miometrio normal en el embarazo. The myometrium, the muscular wall of the uterus, can modify its mass and cellular properties in pregnancy as well as in tumor conditions such as leiomyoma and leiomyosarcoma. Leiomyomas, also known as fibroids, are benign tumors of the uterus, considered to be one of the most frequent causes of infertility in reproductive years of women. Leiomyosarcomas in turn, are rare aggressive malignant uterine smooth-muscle tumors. The present review is discussing the general features of leiomyoma and leiomyosarcoma with their current treatments and also discussing the characteristics of normal pregnant myometrium and compare with leiomyoma.

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