Pregnancy outcome after laparoscopic cryomyolysis of uterine myomas: report of nine cases.
OBJECTIVE
To assess pregnancy course and outcome after laparoscopic cryomyolysis.


METHODS
Open, one-arm, observational clinical pilot study. (Canadian Task Force classification II).


METHODS
University-affiliated public hospital.


METHODS
Nine women who underwent laparoscopic cryomyolysis, with nine pregnancies observed.


METHODS
Laparoscopic cryomyolysis was performed by penetrating along the long axis of the myoma and provoking freezing at temperature -197 degrees C.


RESULTS
After laparoscopic-directed cryomyolysis, pregnant women were evaluated by physical and ultrasonographics examinations. The median time elapsed between cryomyolysis and pregnancy was 14 months (range 7-39 months). At the beginning of pregnancy, the mean volume of myomas was 30.4 mL (range 1.8-124.6 mL). During the first 20 gestational weeks, the mean increase in volume of the nine cryo-treated myomas was 71.1% (range 21.8%-97.7%); the volume of two myomas remained stationary, and two new myomas appeared. Two patients had early miscarriage. Seven pregnancies had a regular course. Four women delivered vaginally, and three by cesarean section. There were no complications in pregnancy, postpartum, and puerperium. No cases of uterine rupture were observed.


CONCLUSIONS
The results of this series of nine pregnancies after laparoscopic cryomyolysis are promising. Laparoscopic cryomyolysis does not compromise a good pregnancy outcome and vaginal delivery. These preliminary data need to be confirmed by larger studies.
Ciavattini
Andrea
A
Institute of Obstetrics and Gynecology, Università Politecnica delle Marche, Ancona, USA. andreac@univpm.it
Tsiroglou
Dimitrios
D
Litta
Pietro
P
Vichi
Maddalena
M
Tranquilli
Andrea Luigi
AL
D000328:Adult; D001034:Apgar Score; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000175:diagnosis / Q000601:surgery*; D008423:Maternal Age; D010865:Pilot Projects; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000601:surgery*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*