Background: Uterine leiomyomas are highly prevalent benign monoclonal tumors, arising from the smooth muscle of the myometrium; The most serious complication of uterine fibroids; is red degeneration that causes severe pain, and may lead to preterm labour, miscarriage, fetal and maternal morbidity and mortality.
Aim: This work was designed to compare between the effect of vaginal natural MP and oral dydrogesterone in prevention
of red degeneration of uterine fibroid during pregnancy.
Material and Methods: Patients were recruited from El-Shatby Maternity University Hospital. They were 50 pregnant females, diagnosed having a uterine fibroid more than 3 cm in size then there were divided into two groups, group (A): twenty five treated by vaginal natural Progesterone, group (B): twenty five treated by oral Dydrogesterone.All patients at 14-15 weeks of gestational age underwent complete history taking, clinical examination and ultrasound examination for mean gestational age and assessment of the type and uterine fibroid.
Results: Results showed that there were no statistical significant differences as regards age, obstetric history (gravidity and parity), number, Site, grade and size of the fibroid. There was a significant difference between the two studied groups, regarding the acute abdominal pain, it occurred to only 3 cases (12%) in group (A), versus to 16 cases (64%) in group (B). Regarding occurrence of red degeneration, it occurred only to 3 cases (12%) in group (A), while in group (B) it occurred to 15 cases (60%).
Conclusion : Vaginal natural micronized progesterone is more effective than oral dydrogesterone in prevention of red degeneration of uterine fibroids with fewer complications like acute abdominal pain and preterm labour