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: Encloscopic 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. (Fertil Steril((R)) 2008;90:1886-91. (c) 2008 by American Society for Reproductive Medicine.)