Treatment of choice of 28 weeks pregnant female with pain due to fibroid in fundus of size 10 X 10 cm is :
**Core Concept**
The management of uterine fibroids in pregnancy involves a multidisciplinary approach, considering both maternal and fetal well-being. The goal is to alleviate symptoms while minimizing risks to the pregnancy.
**Why the Correct Answer is Right**
The treatment of choice for a 28-week pregnant female with a large fibroid causing pain in the fundus is **uterine artery embolization (UAE)**. UAE is a minimally invasive procedure that involves blocking the blood supply to the fibroid, leading to its shrinkage and subsequent pain relief. This approach is preferred over surgical options like myomectomy or hysterectomy, as it reduces the risk of preterm labor and fetal distress.
**Why Each Wrong Option is Incorrect**
**Option A:** **Myomectomy** is a surgical option that involves removing the fibroid while preserving the uterus. However, it is typically reserved for smaller fibroids and is not the preferred treatment for a large fibroid in the second trimester.
**Option B:** **Hysterectomy** is a more radical surgical option that involves removing the uterus. This is generally not recommended for a pregnant female, as it poses significant risks to the pregnancy and is typically reserved for life-threatening complications.
**Option C:** **Uterine artery ligation** is a surgical procedure that involves tying off the uterine artery to reduce blood flow to the fibroid. However, this approach is less effective than UAE and carries a higher risk of complications.
**Clinical Pearl / High-Yield Fact**
When managing uterine fibroids in pregnancy, it is essential to consider the size, location, and symptoms of the fibroid, as well as the gestational age and overall health of the mother.
**Correct Answer:** C. Uterine artery embolization (UAE)