in 2010 think there could be a direct protective effect of pregnancy on fibroids after delivery. When the base of the bladder is involved, urinary retention may occur. One of the main indicators of degenerating fibroid is an acute stabbing pain and swelling in the abdomen. We are a community of more than 103,000 authors and editors from 3,291 institutions spanning 160 countries, including Nobel Prize winners and some of the world’s most-cited researchers. Ectopic pregnancy if it interferes with the passage of the ovum. In cases—as in our patient—where red degeneration is found to be the cause of the pain, conservative management with input from pain specialists is the preferred option. Atypical leiomyoma is differentiated from leiomyosarcoma by a lack of necrotizing tumour cells and a mitotic count less than 7 per 10 HPFs. Contact our London head office or media team here. Publishing on IntechOpen allows authors to earn citations and find new collaborators, meaning more people see your work not only from your own field of study, but from other related fields too. Brief introduction to this section that descibes Open Access especially from an IntechOpen perspective, Want to get in touch? They may manifest with swelling of the abdomen, menorrhagia and infertility. In case of obstructed labour, caesarean section is indicated but myomectomy is contraindicated. The management of pregnant women with uterine fibroids antenatally is usually not different from those without uterine fibroids. Infertility may result because of impaired implantation, tubal function or sperm transport. INTRODUCTION. Uterine fibroids and the severity of their symptoms have a predilection for the black ethnicity. in 2011in Nigeria [19]. Before the advent of ultrasound scanning many women who were pregnant did not know that they had fibroids. But at lower concentrations than the endometrium, this oestrogen may contribute to tumour enlargement by increasing the production of extracellular matrix. It may allow for tumour enlargement by down-regulating apoptosis in the fibroids [16]. They become parasitic when they derive their entire blood supply outside of the uterus, from omental vessels. When uterine fibroids become symptomatic, medical or surgical treatment is offered to the patient, depending on her age, symptoms and future fertility desires. It’s based on principles of collaboration, unobstructed discovery, and, most importantly, scientific progression. Nuclear atypia makes the difference with mitotically active leiomyoma [18]. GnRH agonists induce hypogonadism through pituitary desensitisation, down-regulation of receptors, and inhibition of gonadotropins. Fibroid in pregnancy is a relatively common complication, which aggravates pertaining to increase in size or red degeneration during pregnancy. It evaluates the contour of the uterine cavity and the patency of fallopian tubes but does not evaluate the exact location of fibroids. There, they are subject to torsion or infection. The diagnosis of uterine fibroids is made from the signs and symptoms, pelvic examination, laboratory investigations and imaging. Total abdominal myomectomy maintains fertility compared with hysterectomy but increases recovery time and postoperative pain compared with laparoscopic myomectomy [24]. Fibroids has various symptoms including abnormal or heavy bleeding during periods, swelling in the lower abdomen, weight gain and frequent urination. If because of mistaken diagnosis iaparotomy is done, abdomen is closed without doing anything. As fibroid is common in reproductive age group therefore pregnancy coexisting with fibroid is not uncommon with a prevalence rate estimated at 10.7% in the first trimester.3 Varieties of fibroid degenerations can also occur in pregnancy. It should also be considered in the event of a rapidly enlarging fibroids, in which a reasonable likelihood of malignancy exists. They may also cause pain during sex or lower back pain. Furthermore, black women develop the disease five to six years earlier and their peak age at diagnosis is 40–44 years [7] as opposed to a to peak age of incidence of 35 years observed in Caucasians [1]. It started with a dull ache in my right side that turned to agony. Open Access is an initiative that aims to make scientific research freely available to all. 2. HeadquartersIntechOpen Limited5 Princes Gate Court,London, SW7 2QJ,UNITED KINGDOM. Pain—the most common complication—is usually caused by torsion of a pedunculated fibroid or red degeneration. Red degeneration occurs in 8% of fibroids complicating pregnancy, although the prevalence is about 3% of all uterine leiomyoma. Indications for it include red degeneration not responding to medical therapy, torsion of a pedunculated myoma or internal haemorrhage from rupture of a surface vein [36]. Secondary changes may occur when the fibroids tend to outgrow their blood supply. They are sometimes mistaken to vaginal leiomyomas, which may present with the same clinical features [14]. in 2010, both laparoscopic occlusions of the uterine vessel and embolization improve symptoms associated with uterine fibroids [31]. It now means I am bed bound until the pain reduces, which it might not. In cases—as in our patient—where red degeneration is found … Infection has no role and the process is an, Presentation as a case of an acute abdomen. These may press on nerves within the bony pelvis, creating pain that radiates to the back or lower extremities. Other conditions to be considered include sub involution, congenital anomalies, adherent adnexa, omentum or bowel benign hypertrophy, and sarcoma or carcinoma of the uterus [1]. However, there is high chance of recurrence with myomectomy, while hysterectomy is definitive. Pain—the most common complication—is usually caused by torsion of a pedunculated fibroid or red degeneration. Different types of hysterectomies exist: laparoscopically-assisted vaginal hysterectomy, total vaginal hysterectomy, total abdominal hysterectomy and total laparoscopic hysterectomy.