Document Detail


Pregnancy outcomes following treatment for fibroids: uterine fibroid embolization versus laparoscopic myomectomy.
MedLine Citation:
PMID:  16794420     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The management of uterine fibroids in patients requiring treatment who desire future fertility remains controversial. Myomectomy has been the most common operative procedure to improve pregnancy rates and outcomes. Uterine fibroid embolization is an increasingly popular, minimally invasive treatment for fibroids. This review aims to provide critical analysis of available data on pregnancy following myomectomy and uterine artery embolization. RECENT FINDINGS: Patients with distorted uterine cavities due to submucosal fibroids of more than 2 cm have higher pregnancy rates following hysteroscopic resection. Pregnancy rates following myomectomy, both via laparoscopy and laparotomy, are in the 50-60% range, with most having good outcomes. Pregnancy rates following uterine artery embolization have not been established. Pregnancies following uterine artery embolization had higher rates of preterm delivery (odds ratio 6.2, 95% confidence interval 1.4-27.7) and malpresentation (odds ratio 4.3, 95% confidence interval 1.0-20.5) than pregnancies following laparoscopic myomectomy. SUMMARY: Both myomectomy and uterine artery embolization are safe and effective fibroid treatments, which should be discussed with appropriate candidates. Pregnancy complications, most importantly preterm delivery, spontaneous abortion, abnormal placentation and postpartum hemorrhage, are increased following uterine artery embolization compared to myomectomy. Although most pregnancies following uterine artery embolization have good outcomes, myomectomy should be recommended as the treatment of choice over uterine artery embolization in most patients desiring future fertility.
Authors:
Jay Goldberg; Leonardo Pereira
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in obstetrics & gynecology     Volume:  18     ISSN:  1040-872X     ISO Abbreviation:  Curr. Opin. Obstet. Gynecol.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-06-23     Completed Date:  2006-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007264     Medline TA:  Curr Opin Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  402-6     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA. jaygoldbergmd@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Embolization, Therapeutic*
Female
Humans
Laparoscopy*
Leiomyoma / therapy*
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Uterine Neoplasms / therapy*
Uterus / blood supply

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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