Pregnancy after embolization of uterine myoma: report of 12 cases

Abstract

Objective: To treat uterine myomas with embolization, to look for pregnancy-induced myoma recurrences, and to assess pregnancy course and outcome after embolization. Design: Observational clinical study. Setting: University of Paris VII hospital. Patient(s): Nine women had embolization for symptomatic myoma, with 12 pregnancies observed. Intervention(s): Embolizations were highly selective and performed bilaterally through the uterine arteries with polyvinyl alcohol. Main Outcome Measure(s): Pregnant women were evaluated by physical and sonographic examinations. Result(s): Before embolization, the mean uterine volume was 450 cm 3, and in six patients polymyomas were present. The median age at embolization was 40 years; the median delay before pregnancy was 9 months; and the median age at first pregnancy outcome was 41 years. Five early miscarriages occurred. The seven other pregnancies were uneventful, although three premature births and one case of late toxemia occurred unrelated to previous embolization. Three women delivered vaginally and four by cesarean section. Neither myoma recurrence nor abnormality in uterine function was observed. Conclusion(s): The results of this first series of 12 pregnancies after myoma embolization are promising. If these preliminary results are confirmed, embolization could be a major breakthrough in the management of myoma and could replace conventional medical and surgical treatments.