Treatment of red changes in uterine fibroids

Uterine fibroids may present with various degenerations such as hyaline degeneration, cystic degeneration, fatty degeneration, and red degeneration. Red degeneration is a special type of fibroid necrosis that often occurs during pregnancy or the puerperium and may be related to local tissue ischemia, infarction, congestion, and other causes. The relevant treatment measures are as follows:

Red degeneration of uterine fibroids during pregnancy generally occurs after 4 months of pregnancy. For patients with known uterine fibroids, the diagnosis can be confirmed when severe abdominal pain, fever, enlarged fibroids and tenderness, and elevated white blood cells occur in the middle and late stages of pregnancy or the puerperium. For patients who are not aware of uterine fibroids before pregnancy, diagnosis may be difficult and should be differentiated from ovarian cyst pedicle torsion and pregnancy complicated with appendicitis.

Although the red degeneration is not caused by infection, after the red degeneration, the uterine fibroids will be necrotic due to local blood supply disorder and are susceptible to infection. Therefore, it is generally recommended to use antibacterial drugs that have little effect on the fetus, and give appropriate symptomatic treatments such as sedatives and analgesics. Such patients need to be hospitalized and rest in bed, receive adequate intravenous fluid replacement and general supportive therapy, etc. For those who are ineffective with conservative treatment and whose clinical symptoms worsen (such as persistent high fever, severe and difficult to control pain, or fibroid diameter>6cm, or incarceration that affects continued pregnancy, etc.), surgical treatment is required.