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.