Case reportPregnancy after uterine artery embolization
Section snippets
Case 1
A 33-year-old primigravida at 24 weeks’ gestation experienced premature rupture of membranes. Her antenatal course was complicated by uterine leiomyomata. She had undergone an abdominal myomectomy 6 years prior because of pain and menometrorrhagia. With continued symptoms and additional leiomyomata documented on ultrasound, a uterine artery embolization was performed the following year, 5 years before the described pregnancy. Her symptoms resolved after the embolization.
At the time of the
Case 2
A 42-year-old primigravida with dichorionic twins presented at 26 weeks with preterm labor and cervical dilation of 2 cm. Her antenatal course was complicated by uterine leiomyomata and infertility. Three years before conception she had undergone uterine artery embolization for symptoms of pain and menometrorrhagia. Later that same year she underwent a myomectomy secondary to persistent symptomatic leiomyomata.
The patient then underwent in vitro fertilization, which resulted in the dichorionic
Comment
Uterine artery embolization has been shown to be an effective treatment for symptomatic uterine leiomyomata, although no long-term studies have been published. Spies2 reported improvement in heavy bleeding in 90% (95% confidence interval [CI] 86%, 95%) and bulk symptoms in 91% (95% CI 86%, 95%) at 1 year. Outcomes data regarding women who desire future fertility are less clear and very limited.
In our case 1, because of contributing factors, such as chorioamnionitis, prior myomectomy, and
References (18)
- et al.
Arterial embolisation to treat uterine myomata
Lancet
(1995) - et al.
Uterine artery embolization for leiyomyomata
Obstet Gynecol
(2001) - et al.
Report of a successful delivery after nonsurgical management of a choriocarcinoma-related pelvic arteriovenous fistula
Am J Obstet Gynecol
(1985) - et al.
Pregnancy after transcatheter embolization of a uterine arteriovenous malformation
Am J Obstet Gynecol
(1987) - et al.
Pregnancy after embolization of uterine myomaReport of 12 cases
Fertil Steril
(2000) - et al.
Reply to letter to the editor
Fertil Steril
(2001) Pregnancy following uterine fibroid embolization
Int J Gynaecol Obstet
(2001)- et al.
Conservative treatment of uterine arteriovenous fistula
Acta Obstet Gynecol Scand
(1982) - et al.
Successful pregnancy after selective embolization of a post-molar vascular malformation
Br J Obstet Gynaecol
(1988)
Cited by (164)
Long-term outcome and pre-interventional predictors for late intervention after uterine fibroid embolization
2020, European Journal of Obstetrics and Gynecology and Reproductive BiologyFertility, Pregnancy, and Clinical Outcomes after Uterine Arteriovenous Malformation Management
2019, Journal of Minimally Invasive GynecologyAcquired uterine arteriovenous malformation in caesarean scar after a previous ectopic pregnancy: A case report
2018, European Journal of Obstetrics and Gynecology and Reproductive BiologyExtensive uterine arteriovenous malformation with hemodynamic instability: Embolization for whole myometrium affection
2018, European Journal of Obstetrics and Gynecology and Reproductive BiologyUterine artery embolization: A review of current concepts
2018, Best Practice and Research: Clinical Obstetrics and GynaecologyNonsurgical Alternatives for Uterine Fibroids
2016, Best Practice and Research: Clinical Obstetrics and Gynaecology