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Jefferson researchers find uterine artery embolization may negatively affect future pregnancies

Thomas Jefferson University

A study in the November issue of Obstetrics & Gynecology by physicians at Thomas Jefferson University Hospital in Philadelphia found that women who undergo uterine artery embolization (UAE)--a relatively new procedure that is increasingly used as an alternative to myomectomy and hysterectomy to treat uterine fibroids--are at an increased risk for a number of complications if they later become pregnant.

Fibroids are benign tumors of smooth muscle that grow in the uterus and occur in up to one quarter of women of childbearing age. Fibroids can cause abnormal bleeding, pelvic pain and infertility. Uterine artery embolization is often effective. It is a minimally invasive radiologic procedure that blocks the arteries that supply blood to fibroid tumors, which results in shrinking the tumors by up to 40 percent.

An analysis of 50 published cases of pregnancy after uterine artery embolization by physicians in the Department of Obstetrics and Gynecology at Jefferson Medical College of Thomas Jefferson University in Philadelphia found that pregnant women were at a significantly higher risk for premature delivery, miscarriage, postpartum hemorrhage, breech presentation of the baby and cesarean section.

"Although there is no definitive cause and effect, it is important to be aware of the possible relationship between these complications and prior uterine artery embolization because of the increasing number of women desiring future fertility who are electing to undergo this therapy," says lead author Jay Goldberg, M.D., clinical assistant professor of Obstetrics and Gynecology at Jefferson Medical College.

"Based on the available data, women becoming pregnant after uterine artery embolization may be at significantly increased risk for postpartum hemorrhage, preterm delivery and cesarean delivery," Dr. Goldberg adds.

The study compares complication rates in the following categories:

  • Miscarriage: Rates increased from 10 to15 percent in the general population to 32 percent for women who became pregnant after UAE for fibroids.
  • Postpartum hemorrhage: Rates increased from four to six percent in the general population to nine percent for women who became pregnant after UAE for fibroids.
  • Premature delivery: Rates increased from five to 10 percent in the general population to 22 percent for women who became pregnant after UAE for fibroids.
  • Cesarean delivery: Rates increased from 22 percent in the general population to 65 percent for women who became pregnant after UAE for fibroids.
  • Malpresentation (breech): Rates increased from five percent in the general population to 22 percent for women who became pregnant after UAE for fibroids.

Additional researchers at Jefferson who participated in the study are Leonardo Pereira, M.D., and Vincenzo Berghella, M.D.

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