Year: 2019 | Month: January-March | Volume: 4 | Issue: 1 | Pages: 37-43
Successful 15 Weeks Pregnancy-Preserving Myomectomy in a 35 Years Old Primigravida Presenting a Red Degeneration of Anterior Intramural Corporeal Fibroid and Live Birth at Term: Case Report
A. Gakwavu1, Emmanuel MbonuOsuagwu2, J.D. Rukamba3, F. Habineza4, T. Nizeyimana5, J. A.C.Mukeshimana6, C. Mukamana, E. Habumuremyi, L. Mukamana Marie
1Associate Professor, Chair Person Department of Obstetrics and Gynecology
2Anesthetist Specialist, 3Department of Obstetrics and Gynecology,
4Department of Anesthesiology, 5Department of Imagery. 6Department of Nursing, University of Gitwe.
Corresponding Author: A. Gakwavu
Pain due to red degeneration of fibroid during pregnancy is usually associated with large myomas. Necrobiosis / red degeneration typically manifests itself about midpregnancy when the leiomyoma suddenly becomes acutely painful, enlarged and tender. The common differential diagnoses of this condition are torsion of the pedicle of an ovarian cyst / a leiomyoma, abruption placentae, acute pyelitis or any abdominal catastrophe. Ultrasound can easily delineate the presence of myomas of mixed echogenicity along with pregnancy and clinical findings usually suggest the diagnosis of pregnancy complicated by red degeneration of fibroid. The acute pain usually subsides within 3 - 10 days of conservative treatment. Only refractory cases (2% of patients) may demand surgical intervention in early gestation with the known risk of miscarriage. Here we report a pregnancy managed at 15 weeks by myomectomy for red degeneration causing severe tender enlarged painful gravid uterus non responding to conservative treatment during 6 days. The patient ultimately delivered a healthy male child weighing 3.500 gr at 39 weeks by lower segment caesarean section.
Key words: early pregnancy, red degeneration, myomectomy, cesarean section live birth 3.500 mg.