Uterine artery embolization for symptomatic fibroids: Pros and cons
This procedure—less invasive than hysterectomy or myomectomy—is becoming increasingly popular among patients. Here, a look at the state of the art.
Pregnancy outcomes following myomectomy have been reported in several case series, with rates of premature delivery and other complications similar to those for the general population.22,23 Confounding factors (for example, residual fibroids) and the absence of randomized controlled trials, however, make well-founded comparisons of pregnancy outcomes following UAE and myomectomy difficult.
Theoretical concerns about risk of growth restriction and preeclampsia following UAE have been raised. In our study, we did not observe an increase of small-for-gestational-age infants following embolization.21 Uterine rupture during pregnancy after UAE also has been reported.24
TABLE
Rates of pregnancy complications after UAE and in the general population
| PREGNANCY | COMPLICATIONS OF PREGNANCY % (NUMBER AFFECTED/NUMBER OF SUBJECTS STUDIED) | |||||
|---|---|---|---|---|---|---|
| SPONTANEOUS ABORTION | POSTPARTUM HEMORRHAGE | PREMATURE DELIVERY | CESAREAN DELIVERY | SMALL FOR GESTATIONAL AGE | MAL.* | |
| After UAE for leiomyomata | 32 (11/34) | 9(2/23) | 22 (5/23) | 65 (15/23) | 9 (2/22) | 22 (5/23) |
| In the general population | 10-15 | 4-6 | 5-10 | 22 | 10 | 5 |
| UAE=uterine artery embolization | ||||||
| *MAL=malpresentation | ||||||
| Reprinted from the American Journal of Obstetrics and Gynecology, 100, Goldberg J, Pereira L, Berghella V, Pregnancy after uterine artery embolization, 869-872, 2002, with permission from Elsevier. | ||||||
Internet Resources
- Society of Cardiovascular and Interventional Radiologists (www.SIRweb.org)
- Fibroid Uterine Artery Embolization Registry (www.fibroidregistry.org)
- American College of Obstetricians and Gynecologists (www.acog.org)
The authors report no financial relationships with any companies whose products are mentioned in this article.
