13th Annual Global Embolization Symposium & Technologies
Purpose : Uterine Artery Embolization is one amongst the commonly performed interventional radiological procedures around the world, for a variety of uterine pathologies like leiomyomas, arterio-venous malformation and post-partum haemorrhage. However, the beneficial effects of Uterine Artery Embolization over the surgical treatment have been a debate till date, interrogating the adverse effects of the Uterine Artery Embolization on the fertility and pregnancy of reproductive age group. This study intends to assess the fertility and pregnancy outcomes of patients following Uterine Artery Embolization.
Material and Methods : Retrospective evaluation of patients who had undergone Uterine Artery Embolization in our Interventional Radiology department between January 2012 to January 2018 was performed. Baseline demographic and clinical data such as age, type of uterine pathology and GPLA score prior to the procedure were documented. Procedural data like route of access, choice of embolization agent and procedure related complications were also documented. Post procedural follow up data of the patients on fertility and pregnancy outcomes were obtained with documentation of time interval for first pregnancy after Uterine Artery Embolization, GPLA score after the procedure and type of delivery.
Results : Forty two patients who had undergone Uterine Artery Embolization in our department for various uterine pathologies were evaluated. Fourteen patients were excluded due to age more than 35 years(n=9), completed their family and not willing to get pregnant(n=3) and lost follow up(n=2). Total of twenty eight patients were assessed for fertility and pregnancy outcomes. Age range was 22-35years(Mean:30.2years). Indications for Uterine Artery Embolization were fibroids in 12/28 patients(43%), arterio-venous malformation in 4/28 patients(14%) and post-partum haemorrhage in 12/28 patients(43%). No procedure related complications in all the patients(28/28). Average follow up period was 30 months. 86% of the patients(24/28) had atleast one successful pregnancy after Uterine Artery Embolization and 21% of the patients(6/28) had two successful pregnancies after the procedure. Average time interval for the first pregnancy after the procedure was 15 months(Range: 6 months to 30 months). 62%(15/24) of patients had normal vaginal delivery and 38%(9/24) of patients had caesarean section. 14%(4/28) of the patients hadn’t attained one successful pregnancy after the procedure of which 4%(1/4) didn’t get conceived atleast once and 11%(3/4) had repeated abortions.
Conclusions : From this study, we hereby infer that Uterine Artery Embolization has satisfactory and acceptable outcomes on fertility and pregnancy in reproductive age group patients.