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Full-term vaginal live birth after laparoscopic radiofrequency ablation of a large, symptomatic intramural fibroid: a case report.
MedLine Citation:
PMID:  22523877     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: This case study describes the first reported vaginal delivery following radiofrequency ablation (RFA) of fibroids. The subject was among a cohort of women seeking treatment for symptomatic fibroids. She was enrolled in a clinical trial studying outcomes of laparoscopic, ultrasound-guided RFA of symptomatic fibroids.
CASE: A 38-year-old, G4P3, female was diagnosed with uterine fibroids following a spontaneous abortion and preterm delivery at 21 weeks of a nonviable infant. RFA was performed on 7 fibroids, the largest of which was measured by magnetic resonance imaging (MRI) to be a 6.1-cm, submucosal-intramural, right posterior leiomyoma. The patient conceived approximately 3.5 months after RFA. She had a spontaneous labor at term with an uncomplicated vaginal delivery of a 3,487-g female infant (Apgars: 9, 9). Post-RFA and post-delivery MRI images indicated a myometrial thickness of 9.6 mm throughout, including beneath the ablation site.
CONCLUSION: The lack of a uterine defect following RFA in this case may have allowed this patient to progress to term without uterine rupture as has been reported with conventional myomectomy. The use of RFA in infertile women needs further study, and the decision to perform a cesarean section in women who have had RFA needs to be evaluated. The potential to treat many fibroid patients without requirement for subsequent cesarean section also needs further study.
Authors:
Jay M Berman; Elizabeth E Puscheck; Michael P Diamond
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  57     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-04-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  159-63     Citation Subset:  IM    
Affiliation:
Division of Gynecology, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Hutzel Women's Hospital, 3990 John R, 7 Brush North, Detroit, MI 48201, USA. jberman@med.wayne.edu
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