Red degeneration of uterine fibroids in pregnancy

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

Primiparous woman in her 26th gestational week with known large uterine leiomyomas complained of a dull pain in the left lower quadrant. Ultrasound showed intramural fluid collections in the uterine wall.

Patient Data

Age: 40 years
Gender: Female

Two large hypointense intramural leiomyomas left to the amnion cavity. The more caudally located lesion is surrounded by a large rim of hemorrhage appearing bright on T1- and T2-weighted images. It contains a more recent bleeding component with T2-dephasing. No relation with the placenta. No extrauterine or intraperitoneal fluid collections.

Case Discussion

Fibroid in pregnancy is a relatively common complication, which aggravates pertaining to increase in size or red degeneration during pregnancy.

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