Incidence of Pregnancy Following Uterine Artery Embolization Performed for Uterine Arteriovenous Malformations [22N

Abstract

INTRODUCTION: There are limited data available regarding the rate of success and pregnancy outcomes for women after undergoing embolization for uterine artery arteriovenous malformation (AVM) which mostly comprise of case series and reports with small sample sizes. The purpose of this study is to evaluate fertility and pregnancy outcomes in patients who underwent interventional radiology-guided uterine artery embolization for uterine AVM at our institution. METHODS: IRB approval was obtained. A retrospective chart review was performed from 2008 to present looking at patients who had interventional radiology-guided uterine artery embolization. These patients' charts were reviewed for subsequent pregnancy incidence and outcome of those pregnancies. RESULTS: 37 patients were diagnosed with uterine AVM. 18 chose to undergo UAE. Of those 18 patients, 7 attained subsequent pregnancies. Of the subsequent pregnancies, 4 patients had full-term deliveries and two of these four also had at least one miscarriage. One patient had only a miscarriage without any deliveries, and 1 had a voluntary termination of pregnancy with no other pregnancies documented for the duration of their follow up in our health system. No patients had preterm deliveries. No patients had post-procedure placental abnormalities in their subsequent pregnancies (no documented placenta previa, accreta, or percreta). CONCLUSION: Our data show that successful term pregnancies are possible after IR-guided treatment of uterine AVM. Future multi-institutional prospective studies are required to further prove or disprove results shown in this study. This data has the potential to impact counseling and management for patients who present with uterine artery AVM and desire future fertility.