Red degeneration of uterine leiomyomas during pregnancy: literature review
Keywords:
COMPLICACIONES NEOPLÁSICAS DEL EMBARAZO; EMBARAZO; LEIOMIOMA; NEOPLASIAS UTERINAS.; PREGNANCY COMPLICATIONS, NEOPLASTIC; PREGNANCY; LEIOMYOMA; UTERINE NEOPLASMS.; COMPLICAÇÕES NEOPLÁSICAS NA GRAVIDEZ; GRAVIDEZ; LEIOMIOMA; NEOPLASIAS UTERINAS.Abstract
Introduction: uterine leiomyomas are among the most frequent benign neoplasms in women of reproductive age. During pregnancy, they may undergo degenerative changes, with red degeneration being an uncommon variant that generates relevant obstetric complications.
Objective: to analyze the available evidence on red degeneration of uterine leiomyomas in pregnant women, describing their clinical, diagnostic, and therapeutic management characteristics.
Methods: a systematic review of the scientific literature was conducted across several databases. The search was performed using an algorithm with keywords and Boolean operators, allowing the identification of relevant sources. Selected studies, after applying inclusion and exclusion criteria, were critically analyzed considering timeliness, methodological quality, and thematic relevance.
Development: the reviewed studies show that red degeneration occurs in a small percentage of fibroids during pregnancy, mainly presenting with acute abdominal pain and characteristic findings on ultrasound and magnetic resonance imaging. Conservative management, focused on pain control and prenatal monitoring, is usually sufficient in most cases. However, complications such as preterm birth, fetal growth restriction, and higher cesarean rates are reported. Surgery is reserved for emergency situations due to maternal-fetal risk. A multidisciplinary approach and close follow-up are essential to optimize clinical outcomes.
Conclusions: red degeneration of uterine leiomyomas during pregnancy, although infrequent, represents a significant clinical challenge. Timely diagnosis through imaging and conservative management help reduce risks, although an increase in obstetric complications persists.
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