Pregnancy after uterine artery embolization for the treatment of myomas: a case series.
OBJECTIVE
Uterine artery embolization (UAE) has become an alternative therapy for the treatment of symptomatic myomas. The questions of fertility and pregnancy outcome after uterine artery embolization are still not answered. The study presents the results of pregnancies after UAE. The main goal was to evaluate the course of these pregnancies and concentrate on possible complications.


METHODS
This was a prospective study from June 2009 till October 2011. Patients with symptomatic uterine myomas were included. The evaluation of the symptoms was done by quality of life questionnaire and bleeding charts. UAE was performed by superselective microcatheterization technique. Women still planning pregnancy were included in the study after signing detailed informed consent. Pregnant women after UAE were followed as high-risk pregnancies.


RESULTS
A total of 98 patients underwent uterine artery embolization for symptomatic myomas; 21 expressed their wish to become pregnant, out of which 6 had successful spontaneous conception (23.08 %) and 1 patient was pregnant twice, and altogether there were seven pregnancies. During gestation and delivery, there was no serious complication. There was one missed abortion and one placental retention. Myomas did not show growth pattern during pregnancy.


CONCLUSIONS
Data from further prospective, randomized trials comparing fertility and pregnancies after UAE with other treatment modalities are needed. UAE, with the new techniques of superselective microcatheterization, could be, in the future, a possible approach even in women with future maternity plans.
II Department of Gynaecology and Obstetrics, University Hospital, Comenius University, Bratislava Ružinovská 6, 826 06 Bratislava, Slovakia. mikiinus@yahoo.com
Mikuláš
M
Redecha
Magdaléna
M
Mižičková
Vladimír
V
Javorka
Martin
M
Redecha
Sylvia
S
Kurimská
Karol
K
Holomáň
D000030:Abortion, Missed / Q000453:epidemiology; D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005298:Fertility; D006801:Humans; D007231:Infant, Newborn; D007889:Leiomyoma / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055357:Uterine Artery Embolization / Q000009:adverse effects*; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*