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Magnetic Resonance Imaging (MRI) Analysis of Fibroid Location in Women Achieving Pregnancy After Uterine Artery Embolization

CardioVascular and Interventional Radiology volume 30, pages 876–881 (2007)Cite this article

Abstract

The purpose of this study was to evaluate the fibroid morphology in a cohort of women achieving pregnancy following treatment with uterine artery embolization (UAE) for symptomatic uterine fibroids. A retrospective review of magnetic resonance imaging (MRI) of the uterus was performed to assess pre-embolization fibroid morphology. Data were collected on fibroid size, type, and number and included analysis of follow-up imaging to assess response. There have been 67 pregnancies in 51 women, with 40 live births. Intramural fibroids were seen in 62.7% of the women (32/48). Of these the fibroids were multiple in 16. A further 12 women had submucosal fibroids, with equal numbers of types 1 and 2. Two of these women had coexistent intramural fibroids. In six women the fibroids could not be individually delineated and formed a complex mass. All subtypes of fibroid were represented in those subgroups of women achieving a live birth versus those who did not. These results demonstrate that the location of uterine fibroids did not adversely affect subsequent pregnancy in the patient population investigated. Although this is only a small qualitative study, it does suggest that all types of fibroids treated with UAE have the potential for future fertility.

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References

  1. Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG 109:1262–1272

    PubMed  Article  CAS  Google Scholar 

  2. Walker WJ, Barton-Smith P (2006) Long-term follow-up of uterine artery embolisation-an effective alternative in the treatment of fibroids. BJOG 113(4):464–468

    PubMed  Article  CAS  Google Scholar 

  3. Watson GM, Walker WJ (2002) uterine artery embolisation for the treatment of symptomatic fibroids in 114 women: reduction in size of the fibroid and womens’ views of the success of the treatment. BJOG 109(2):129–135

    PubMed  Article  CAS  Google Scholar 

  4. Goodwin SC, McLucas B, Lee M, et al. (1999) Uterine artery embolization for the treatment of uterine leiomyomata: mid-term results. J Vasc Interv Radiol 10:1159–11165

    PubMed  CAS  Google Scholar 

  5. Spies JB, Ascher SA, Roth AR, Kim J, Levy EB, Gomez-Jorge J (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34

    PubMed  Article  CAS  Google Scholar 

  6. Pron G, Bennett J, Common A, Wall J, Asch J, Sniderman K (2003) The Ontario uterine fibroid embolization trial: uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 79:120–127

    PubMed  Article  Google Scholar 

  7. Goldberg J, Pereira L, Berghella V (2002) Pregnancy after uterine artery embolisation. Obstet Gynecol 100:869–72

    PubMed  Article  Google Scholar 

  8. Vashisht A, Smith J R, Thorpe-Beeston G, McCall J (2001) Pregnancy subsequent to uterine artery embolisation. Fertil Steril 75:1246–1248

    PubMed  Article  CAS  Google Scholar 

  9. Kovacs P, Stangel JJ, Santoro NF, Lieman H (2002) Successful pregnancy after transient ovarian failure following treatment of symptomatic leiomyoma. Fertil Steril 77:1292–1295

    PubMed  Article  Google Scholar 

  10. Pietura R, Jakiel G, Swatowski D, Semczuk M, Szczerbo-Trojanowska M (2005). Pregnancy 4 months after uterine artery embolization. CardioVasc Interv Radiol 28(1):117–119

    Article  CAS  Google Scholar 

  11. Boulleret C, Chahid T, Gallot D, Mofid R, Tran Hai D, Ravel A, Garcier JM, Lemery D, Boyer L (2004). Hypogastric arterial selective and superselective embolization for severe postpartum hemorrhage: a retrospective review of 36 cases. CardioVasc Interv Radiol 27(4):344–348

    Article  CAS  Google Scholar 

  12. D’Angelo AD, Amso NN, Wood A (2003) Spontaneous multiple pregnancy following uterine artery embolisation for uterine fibroid : a case report. Eur J Obstet Gynecol Reprod Biol 110:245–246

    PubMed  Article  Google Scholar 

  13. Carpenter TT, Walker WJ (2005) Pregnancy following uterine artery embolisation for symptomatic fibroids: a series of 26 completed pregnancies. BJOG 112:321–325

    PubMed  Article  CAS  Google Scholar 

  14. Walker WJ, McDowell SJ (2006) Pregnancy after uterine artery embolisation for leiomyomata: a series of 56 completed pregnancies. Am J Obstet Gynecol 195(5):1266–1271

    PubMed  Google Scholar 

  15. Pron G, Mocarski E, Bennett J, Vilos G, Common A, Vanderburgh L (2005) Pregnancy after uterine artery embolisation for leiomyomata: The Ontario Multicenter Trial. Obstet Gynecol 34:664–666

    Google Scholar 

  16. Kim MD, Kim NK, Kim HJ, Lee MH (2005) Pregnancy following uterine artery embolization with polyvinyl alcohol particles for patients with uterine fibroid or adenomyosis. CardioVasc Interv Radiol 28:611–615

    Article  Google Scholar 

  17. Ravina JH, Cirau-Vigneron N, Aymard A, Le Dref O, Merland JJ (2000) Pregnancy after embolization of uterine myoma: a report of 12 cases. Fertil Steril 73:1241–1243

    PubMed  Article  CAS  Google Scholar 

  18. McLucas B, Goodwin S, Adler L, Rappaport A, Reed R, Perrella R (2001) Pregnancy following uterine artery embolisation. Int J Gynael Obstet 74:1–7

    Article  CAS  Google Scholar 

  19. Ciraru-Vigneron N, Ravina JH (2001) Pregnancy subsequent to uterine artery embolisation. Fertil Steril 75:1247–1248

    Article  Google Scholar 

  20. Forman RG, Reidy J, Nott V (1999) Fibroids and fertility. Min Invas Ther Allied Technol 8:415–419

    Article  Google Scholar 

  21. Anderson PE, Lund N, Justesen P, et al. (2001) Uterine artery embolisation of symptomatic fibroids: initial success and short-term results. Acta Radiol 42:234–238

    Google Scholar 

  22. Wamsteker K, Emanuel MH, de Kruif JH (1993) Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol 82:736–740

    PubMed  CAS  Google Scholar 

  23. Coutino VS, Maie HS (1971) The contractile response of the human uterus fallopian tubes and ovary to prostaglandins in vivo. Fertil Steril 22:539–543

    Google Scholar 

  24. Deligdish L, Lowenthal M (1970). Endometrial changes associated with myomata of the uterus. J Clin Pathol 23:676–680

    PubMed  Article  CAS  Google Scholar 

  25. Forsaman L (1976) Venous changes in the endometrium of the myomatous uterus as measured by locally injected 133 xenon. Acta Obstet Gynecol Scand 55:101–104

    Google Scholar 

  26. Jacobson F N, Enzer N (1956) Uterine myomas and endometrium. Obstet Gynecol 7:206–210

    PubMed  CAS  Google Scholar 

  27. Iosif CS, Akerlund M (1983) Fibromyomas and uterine activity. Acta Obstet Gynecol Scand 762:165–167

    Article  Google Scholar 

  28. Pritts EA (2001) Fibroids and infertility: a systematic review of the evidence. Obstet Gynecol Surv 56(8):483–491

    PubMed  Article  CAS  Google Scholar 

  29. Varasteh N, Neuwirth R, Levin B, Keltz MD (1999) Pregnancy rates after hysteroscopic polypectomy and myomectomy in infertile women. Obstet Gynecol 94:168–171

    PubMed  Article  CAS  Google Scholar 

  30. Narayan R, Goswany RK (1994). Treatment of submucous fibroids, and outcome of assisted reproduction. J Am Assoc Gynecol Laparosc 1:307–311

    PubMed  Article  CAS  Google Scholar 

  31. Fauconnier A, Dubuisson JB, Ancel PY, Chapron C (2000) Prognostic factors of reproductive outcome after myomectomy in infertile patients. Hum Reprod 15:1751–1757

    PubMed  Article  CAS  Google Scholar 

  32. Ozeren M, Ulusoy M, Uyanik E (1997) First trimester spontaneous uterine rupture after traditional myomectomy: a case report. Isr J Med Sci 33:752–753

    PubMed  CAS  Google Scholar 

  33. Dubuisson JB, Chapron C, Morice P (1994) Uterine rupture during pregnancy after laparoscopic myomectomy. Hum Reprod 10:1475–1477

    Google Scholar 

  34. Cravello L, Agostini A, Beerli M, Roger V, Bretelle F, Blanc B (2004) Results of hysteroscopic myomectomy. Gynecol Obstet Fertil 32(9):825–828

    PubMed  Article  CAS  Google Scholar 

  35. Stancato-Pasik A, Mitty H, Richard HM, Eshkar N (1997) : Obstetric embolotherapy; effect on menses and pregnancy. Radiology 204:791–793

    PubMed  CAS  Google Scholar 

  36. Burn PR, McCall JM, Chinn RJ, Vashisht A, Smith JR, Healy JC (2000) Uterine fibroleiomyoma: MR imaging appearances before and after embolization of uterine arteries. Radiology 213:729–734

    Google Scholar 

  37. Colgan TJ, Pron G, Mocarski E (2003) Pathologic features of uteri and leiomyomas following uterine artery embolization for leiomyomas. Am J Surg Pathol 27:167–177

    PubMed  Article  Google Scholar 

  38. Goldberg J, Pereira L, Berghella V, Diamond J, Darai E (2004) Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy. Am J Obstet Gynecol 191(1):18–21

    PubMed  Article  Google Scholar 

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Acknowledgments

We would like to acknowledge our deepest gratitude to Rose Nielsen, Research Assistant, for her dedicated and exhaustive work on the data for this article; without her endeavor and commitment, it would not have been possible.

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Affiliations

  1. Department of Radiology, Royal Surrey County Hospital, Egerton Road, Guildford, UK

    Woodruff J. Walker

  2. Department of Radiology, St George’s Hospital, Blackshaw Road, Tooting, London, SW17 OQT, UK

    Mark John Bratby

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  1. Woodruff J. Walker
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  2. Mark John Bratby
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Correspondence to Mark John Bratby.

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Walker, W.J., Bratby, M.J. Magnetic Resonance Imaging (MRI) Analysis of Fibroid Location in Women Achieving Pregnancy After Uterine Artery Embolization. Cardiovasc Intervent Radiol 30, 876–881 (2007). https://doi.org/10.1007/s00270-007-9118-2

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  • DOI: https://doi.org/10.1007/s00270-007-9118-2

Keywords

  • Pregnancy
  • Uterine myoma
  • Uterine artery embolization
  • Magnetic resonance imaging