Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy.
OBJECTIVE
The objective of this study was to compare pregnancy outcomes in women with fibromyomata who were treated with uterine artery embolization to the outcomes in women who were treated with laparoscopic myomectomy.


METHODS
We compiled data from 53 pregnancies after uterine artery embolization and 139 pregnancies after laparoscopic myomectomy. We calculated and compared rates for spontaneous abortion, postpartum hemorrhage, preterm delivery, cesarean delivery, small for gestational age, and malpresentation.


RESULTS
Pregnancies after uterine artery embolization had higher rates of preterm delivery (odds ratio, 6.2; 95% CI, 1.4, 27.7) and malpresentation (odds ratio, 4.3; 95% CI, 1.0, 20.5) than did pregnancies after laparoscopic myomectomy. The risks of postpartum hemorrhage (odds ratio, 6.3; 95% CI, 0.6, 71.8) and spontaneous abortion (odds ratio, 1.7; 95% CI, 0.8, 3.9) after uterine artery embolization were similarly higher than the risks after laparoscopic myomectomy; however, these differences were not statistically significant.


CONCLUSIONS
Pregnancies in women with fibromyomata who were treated by uterine artery embolization, compared with pregnancies after laparoscopic myomectomy, were at increased risk for preterm delivery and malpresentation.
Department of Obstetrics and Gynecology, Jefferson Medical College, Philadelphia, PA 19107, USA. jay.goldberg@jefferson.edu
Jay
J
Goldberg
Leonardo
L
Pereira
Vincenzo
V
Berghella
James
J
Diamond
Emile
E
Daraï
Piero
P
Seinera
Renato
R
Seracchioli
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D001158:Arteries; D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007889:Leiomyoma / Q000601:surgery / Q000628:therapy*; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D016017:Odds Ratio; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000601:surgery / Q000628:therapy*; D014599:Uterus / Q000098:blood supply