Pregnancy following uterine artery embolisation for symptomatic fibroids: a series of 26 completed pregnancies

Objectives To evaluate the outcome of pregnancies after uterine artery embolisation for uterine fibroids. Design Retrospective analysis of pregnancy subsequent to uterine artery embolisation by one interventional radiologist. Setting A UK District General Hospital. Population Twenty-nine pregnancies in 671 women who had undergone uterine artery embolisation. Methods Cases were identified by screening questionnaire and from the study database. Detailed information was collected by questionnaires, direct conversations with women and, when necessary, from hospital records. Main outcome measures Pregnancy outcome, complications and neonatal outcomes. Results Of 26 completed pregnancies, detailed information was available for 24 and limited information for 2. Seven (27%) ended in miscarriage, there were two terminations and one ectopic pregnancy. Of 16 deliveries after 24 weeks, first and second trimester bleeding occurred in 40% and 33%, respectively, 4 (25%) had preterm deliveries and the caesarean section rate was 88%. Two (13%) women developed proteinuric hypertension and two others had preterm spontaneous rupture of the membranes. Fourteen of 16 cases were delivered by caesarean section. The rate of primary postpartum haemorrhage was 3/15 (20%). The mean birthweight of term babies was 3.39 kg (SD 0.64) and none required admission to neonatal intensive care. There was one (6.7%) case of fetal growth restriction. Conclusion Although this study is relatively small, there is an increase in delivery by caesarean section. There does not appear to be any other major excess obstetric associated risk when the demographics of the population in question is considered.