Pregnancy Following Uterine Fibroid Embolization
- Created: April 6, 2001
- by: admin
By: Bruce McLucas, MD, Scott Goodwin, MD, Louis Adler, MD, Arnold Rappaport, MD, Richard Reed, MD, Rita Perrella, MD INTERNATIONAL JOURNAL OF GYNECOLOGY AND OBSTETRICS
July 2001 Volume 74 No. 1 pp. 1-7
CONDENSATION Thirty-three percent of women under 40 desiring pregnancy have experienced pregnancies following uterine fibroid embolization. Possible impediments to Post UFE pregnancy are discussed.
OBJECTIVE This paper seeks to evaluate the ability to deliver term pregnancies following uterine fibroid embolization, and to identify impediments to pregnancy in the embolization procedure.
STUDY DESIGN Four physicians performed embolization procedures at different facilities. Patients were asked if fertility was an issue prior to embolization. We measured follicle-stimulating hormone before and after embolization. Clinical follow-up six months following embolization was obtained by interview. Patients were questioned regarding attempts to conceive, menstrual history, and subsequent pregnancy.
MAIN OUTCOME MEASURES Complications were calculated upon the entire patient population, whether or not fertility was identified as a goal. Fertility risks from embolization were identified. We measured radiation exposure in a random consecutive group of 50 women undergoing embolization. All patients who conceived were asked the details of the pregnancy.
RESULTS Four hundred women underwent uterine fibroid embolization between 1996 and 1999. One hundred thirty nine patients stated a desire for fertility after embolization. Of these, 52 were ages 40 years or less. Seventeen pregnancies have been reported in 14 women. Five miscarriages were observed. Ten women have had normal term deliveries, two women are currently pregnant. No perfusion problems either during the pregnancy or labor were reported. The average radiation dosage calculated for 50 women undergoing embolization was 14 rads. Four women under 45 years old suffered premature menopause [10/1,000]. Two women underwent hysterectomy as a complication of embolization [5/1,000].
CONCLUSION The risks of infertility following embolization, premature menopause and hysterectomy, are small, as is the radiation exposure during embolization. These risks compare favorably with those associated with myomectomy. Fertility rates appear similar to patients undergoing myomectomy. No problems either during pregnancy or delivery have been observed after embolization. The course of pregnancy and delivery was normal after embolization with no maternal or fetal complications reported. These findings confirm results from other centers. Desire for future pregnancy is not a contraindication to fibroid embolization.
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