Pregnancy outcomes after uterine artery occlusion: prospective multicentric study

Objective To assess the reproductive outcomes after laparoscopic uterine artery occlusion (LUAO) and uterine artery embolization (UAE) in women with symptomatic fibroids. Design Prospective, clinical multicentric study. Setting Endoscopic center in the department of obstetrics and gynecology at a hospital in the Czech Republic. Patient(s) Thirty-eight pregnant women after LUAO and 20 pregnant women after UAE. Intervention(s) Laparoscopic uterine artery occlusion and UAE. Main Outcome Measure(s) Pregnancy, abortion, preterm delivery, and live-birth rates. Result(s) Pregnancies after uterine embolization had a statistically significantly higher rate for spontaneous abortion (56%) than did pregnancies after surgical uterine artery occlusion (10.5%). The risk of malpresentation (20%) and the rate for cesarean section (80%) after UAE similarly were higher than was the risk after laparoscopic occlusion; however, these differences were not statistically significant. Also, there were no significant differences between the groups in preterm deliveries (15.3% in the LUAO group vs. 20% in the UAE group). Conclusion(s) Pregnancies of women who were treated with uterine embolization were at significantly increased risk for spontaneous abortion when compared with pregnancies of women treated with LUAO.