A minimally invasive procedure called uterine artery embolisation is an increasingly popular treatment for fibroids, benign growths in the uterus. However, recent research suggests that this procedure may make future pregnancies more difficult by increasing the risk of preterm delivery.
Typically, only fibroids that cause symptoms are treated. Such fibroids can be removed with an operation called myomectomy. The growths can also be shrunk with uterine artery embolisation, which involves the injection of tiny particles to cut off the fibroid's blood supply.
Researchers form the Jefferson Medical College in Philadelphia, USA, did a comparison of 53 pregnancies that occurred after uterine artery embolisation and 139 that occurred after laparoscopic myomectomy.
The researchers looked at a variety of complications, such as spontaneous abortion, preterm delivery, and an abnormally positioned fetus. Compared with myomectomy, treatment with uterine artery embolisation raised the risks of preterm delivery and an abnormally positioned fetus by 6.2 and 4.3 times, respectively. Uterine artery embolisation was also linked to higher rates of postpartum bleeding and spontaneous abortion, but these differences could have simply been a chance finding.
The researchers said that studies directly comparing uterine artery embolisation with myomectomy are needed before embolisation can be considered a safe treatment for patients who plan to have children.
American Journal of Obstetrics and Gynecology ,
August 2004
August 2004