Pregnancy After Uterine Artery Embolization for Symptomatic Fibroids: A Series of 15 Pregnancies

Abstract

The purpose of this study was to report on pregnancies and their outcome after uterine artery embolization for uterine fibroids. From 2001 to 2004, 102 patients (mean age, [+/- SD] 35.7 +/- 6.4 years; range, 20-48 years) with symptomatic uterine fibroids underwent uterine artery embolization with 500- to 710-microm polyvinyl alcohol particles. The mean uterine volume was 552 +/- 649 cm(3) (range, 94-4,656 cm(3)), and the dominant fibroid size was 228 +/- 359 cm(3) (range, 14-2,618 cm(3)) before the procedure. During the 2-year follow-up period, the patients were asked whether they were trying to achieve pregnancy and whether they were successful. We obtained pregnancy and obstetric records of the pregnant women from physicians' offices and hospitals. Among 102 women who underwent bilateral uterine artery embolization, 23 (22.5%) were seeking to become pregnant, and 14 of the 23 (61%) became pregnant, nine having been nulliparous. One patient had two pregnancies. Fourteen pregnancies were spontaneous, and one was achieved by zygote intrafallopian transfer. Two miscarriages occurred, one in the 12th and one in the 16th week of gestation. The other 13 pregnancies went to term, were uncomplicated, and ended in elective cesarean delivery. All of the neonates were healthy with Apgar scores greater than 8. The mean weight of the neonates was 3,274 +/- 514.4 g (range, 2,100-3,950 g). One neonate was small for gestational age (2,100 g). Uterine artery embolization can serve as a substitute for invasive operations such as hysterectomy and myomectomy. Additional studies, including prospective, randomized comparisons with myomectomy, should be performed to ascertain whether uterine artery embolization is a safe procedure for women who want to preserve their fertility.