Spontaneous Pregnancy with a Live Birth after Conventional and Partial Uterine Fibroid Embolization

João Martins Pisco, Pisco JM, João M Pisco, Duarte M, Marisa Duarte, Tiago Bilhim, Bilhim T, Jaime Branco, Branco J, Jorge Branco, Cirurgião F, Fernando Cirurgião, Marcela Forjaz, Forjaz M, Fernandes L, Lúcia Fernandes, Janice Machado Camargo Pereira, José Pereira, Pereira J, Costa N, Nuno Costa, Nuno Vasco Costa, Joana B. M. Pisco, Pisco JBM, Oliveira AG, António Gouveia Oliveira, António G Oliveira
Radiology · 2017 · vol. 285(1) , pp. 302–310 · doi:10.1148/radiol.2017161495 · PMID:28608747 · W2625540950
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This study analyzed 359 women with uterine fibroids undergoing conventional or partial uterine fibroid embolization, finding 29.5% spontaneous pregnancies at 1 year and 40.1% at 2 years with good symptom relief.

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Abstract

Purpose To determine pregnancy rates after conventional and partial uterine fibroid embolization (UFE). Materials and Methods The study received institutional review board approval and all patients gave written informed consent. A retrospective analysis of data collected prospectively was performed between June 2004 and June 2014 in a cohort of 359 women (mean age, 35.9 years ± 4.8) with uterine fibroids and/or adenomyosis who were unable to conceive. The median follow-up period was 69 months (range, 6-126 months). Under local anesthesia, both uterine arteries were embolized. In 160 patients, partial embolization was intentionally performed to preserve fertility, which may be decreased after conventional UFE. In partial UFE, only the small arterial vessels to the fibroids were embolized, leaving the large vessels of the fibroids patent. The Kaplan-Meier method and Cox regression were used for the statistical analysis. Results During follow-up, 149 women became pregnant, 131 women had live births, and 16 women had several pregnancies, resulting in a total of 150 live newborns. It was the first pregnancy for 85.5% (112 of 131) of women. Spontaneous pregnancy rates at 1 year and 2 years after UFE were 29.5% and 40.1%, respectively. The probability of successful pregnancy with live birth at 1 year and 2 years was 24.4% and 36.7%, respectively. Clinical success for fibroid-related symptoms was 78.6% (282 of 359). A dominant submucosal fibroid and ischemia greater than or equal to 90% had greater likelihood of spontaneous pregnancy. Complication rates in patients treated with partial UFE (14.6%) were not greater than rates in patients treated with conventional UFE (23.1%, P = .04). Conclusion Conventional and partial UFE may be safe and effective outpatient procedures for women with uterine fibroids who want to conceive. © RSNA, 2017.

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Condition tags

adenomyosis

MeSH descriptors

Embolization, Therapeutic Leiomyoma Leiomyoma Leiomyoma Leiomyoma Live Birth Live Birth Uterine Neoplasms Uterine Neoplasms Uterine Neoplasms Uterine Neoplasms Adult Adult Angiography, Digital Subtraction Angiography, Digital Subtraction Embolization, Therapeutic Embolization, Therapeutic Female Female Humans

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References (28)

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