Analysis of High-Risk Factors for Failure of Bleeding Control in Enhanced Myometrial Vascularity Treated With Uterine...

Enhanced myometrial vascularity (EMV) is a condition frequently linked to abnormal uterine bleeding during pregnancy, leading to significant morbidity, including severe bleeding and anemia. It poses a considerable economic burden on healthcare systems. This study aims to explore the factors influencing treatment outcomes in patients undergoing uterine artery embolization (UAE) for bleeding from EMV.

A retrospective analysis was performed on 110 patients treated with UAE in the Women's Hospital, Zhejiang University School of Medicine, yielding a success rate of 94 out of 110 cases. Sixteen patients with treatment failure were included in the study group, and 94 successfully treated patients were included in the control group.

Key findings revealed that patients in the study group were younger, presented with larger uterine EMV diameters, had longer intervals since their last uterine surgery, and more frequently exhibited uterine fundal involvement (p < 0.05). Binary logistic regression analysis identified diameter of uterine EMV (OR = 3.23, 95% CI: 1.59-8.51, p < 0.05) and uterine fundal involvement (OR = 74.03, 95% CI: 7.88-697.40, p < 0.05) as significant risk factors for treatment failure. Postoperative follow-up demonstrated that the treatment failure group had significantly prolonged bleeding times and a higher incidence of unchanged or enlarged malformations compared with the successful treatment group (p < 0.05).

These findings suggest that EMV size and uterine fundal involvement are critical determinants of UAE treatment failure, providing important evidence for clinical risk assessment and future research on the management of EMV-related bleeding.