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Pregnancy after Uterine Fibroid Embolization

Journal: Fertil Steril. 2010 Sep 24. [Epub ahead of print]

Authors: Pisco JM, Duarte M, Bilhim T, Cirurgião F, Oliveira AG.

Study from: Department of Radiology, St. Louis Hospital; New University of Lisbon, Portugal.

Problem: The safety of pregnancy following embolization (UAE) is uncertain because there have been few publications examining this issue.

Study: In a single hospital in Portugal, UAE was performed in 74 patients who wanted to become pregnant.

Results: Of the 74 women who wanted to become pregnant, 44 of them became pregnant (59.5%). Thirty-nine women completed pregnancies resulted in 33 successful live births (84.6%), four miscarriages (10.3%), one induced abortion, and one stillbirth. Two women delivered early, at 36 weeks (6.1%), and five babies were low birth-weight. At the time of publication, five other women had ongoing pregnancies.

Authors’ Conclusions: Pregnancy after UAE appears to be safe.

Dr. Parker’s Comments: Although this is a small study (only 44 pregnant women), it is reassuring. An earlier study from Toronto found a slightly higher risk of bleeding from the placenta or difficulty removing the placentas after delivery in women who had UAE. The current study did not find these problems. Unfortunately, there are very few studies of women who have had a myomectomy before getting pregnant to see if there were any problems with their pregnancies.

Many interventional radiologists do not perform UAE for women who wish to get pregnant and I wonder if this new information will change their opinions. Personally, I will advise women about this study and suggest that there is less reason to be nervous about getting pregnant after UAE. It would be nice to have more information to help advise women regarding the outcomes of pregnancies for women who get pregnant with fibroids, and for women who have had UAE or myomectomies.

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