Interventional Radiology in Women’s Health

Abstract

The emergence of interventional radiology procedures has provided significant benefit to the management of certain obstetrical and gynecologic patients. Using percutaneous minimally invasive techniques, interventional radiologists are able to reduce patient discomfort and surgical morbidity as well as perform procedures under sedation instead of general anesthesia. Interventional radiology procedures focus on the treatment of uterine leiomyomas, postpartum hemorrhage, placenta accreta, and pelvic congestion syndrome and the placement of inferior vena cava filters in pregnancy. In addition, interventional radiologists manage several nonvascular pathologies including fallopian tube recanalization, drainage of pelvic abscesses and fluid collections, and image-guided biopsy of ovarian or adnexal lesions. Major challenges with obstetric procedures include the need to minimize patient and fetal radiation dose and the desire to maintain future fertility. This chapter will provide an introduction to the obstetric and gynecologic procedures used for intervention in their pathologies listed above as well as fallopian tube recanalization. Drainage of pelvic abscesses and fluid collections as well as image-guided biopsy of pelvic lesions is discussed broadly in the biopsy and drainage chapter of this book.