Successful pregnancy following both endometrial ablation and uterine artery embolization

Abstract

To present a description of the management of a pregnancy in a woman who had undergone endometrial ablation and uterine artery embolization for fibroids. Case report. Division of Maternal Fetal Medicine within a tertiary community-based teaching hospital. A 43-year-old G2P1 woman who had undergone a hydrothermal ballon ablatation and a bilateral, nonselective embolization. Management of a high-risk pregnancy. Successful pregnancy. The patient was prophylactically treated with 250 mg of 17 alpha-hydroxyprogesterone intramuscularly weekly, beginning at 16 weeks gestation, received a rescue McDonald cerclage at 22 weeks and 4 days, and remained on modified bed rest at home. Ultrasonically estimated fetal weights were in the 30th to 40th percentile. At 35 4/7th weeks she presented with uterine pain. Ultrasound revealed fundal elevation of the amniotic membranes, estimated fetal weight had decreased to the 20th percentile and a biophysical profile score of 4/10 was obtained. A cesarean resulted in the delivery of a vigorous infant weighing 2466 g. With aggressive therapy, successful pregnancy is possible in similar patients.