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Pregnancy after uterine artery embolization for leiomyomata: a series of 56 completed pregnancies
Woodruff J Walker1, Simon J McDowell
1Department of Radiology, The Royal Surrey County Hospital, Guildford, UK. wj.walker@virgin.net
Objective:
This study was undertaken to evaluate the incidence and outcome of pregnancies after uterine artery embolization (UAE) for symptomatic uterine fibroids.
Study Design:
A retrospective analysis of all pregnancies after UAE by a single interventional radiologist.
Results:
Fifty-six completed pregnancies were identified in approximately 1200 women after UAE. One hundred eight patients were attempting to become pregnant and 33 of these became pregnant. Thirty-three (58.9%) of the 56 pregnancies had successful outcomes. Six (18.2%) of these were premature. Seventeen (30.4%) pregnancies miscarried. There were 3 terminations, 2 stillbirths, and 1 ectopic pregnancy. Of the 33 deliveries, 24 (72.7%) were delivered by cesarean section. There were 13 elective sections and the indication for 9 was fibroids. There were 6 cases of postpartum hemorrhage (18.2%).
Conclusion:
Compared with the general obstetric population, there is a significant increase in delivery by cesarean section and an increase in preterm delivery, postpartum hemorrhage, miscarriage, and lower pregnancy rates. When taking into account the demographics of the study population, these results can be partly explained. There were no other obstetric risk identified.