Pregnancy possible after fibroid treatment

One of the newest treatments for fibroids, a procedure called uterine artery embolization (UAE) that cuts off blood to the benign tumors, is usually considered only suitable for women who have finished having babies. However, women can conceive and carry a child to term following UAE, a Canadian team reports.

Nonetheless, women who become pregnant after UAE should be closely monitored for abnormal development of the placenta, the group advises.

"UAE is now recognized as a solid alternative to hysterectomy for women with symptomatic fibroids,” Dr. Gaylene Pron from the University of Toronto told AMN Health, but little is known about the effect of UAE on fertility and pregnancy.

In the medical journal Obstetrics and Gynecology, Pron and Ontario-based colleagues report on pregnancies and deliveries among 555 women who underwent UAE as an alternative to hysterectomy as part of a clinical trial.

The average age of the participants was 43 years, but 31 percent were younger than 40.

The investigators report that 21 of the women conceived after the procedure, and three of the women became pregnant twice.

This shows that “women can definitely get pregnant after UAE. So if they were told that they cannot, that would not be true and it could cause a lot of problems if they are not using any contraception,” Pron pointed out.

Twenty-three of the 24 pregnancies were conceived spontaneously. There were four spontaneous abortions, a rate of about 17 percent, which is similar to that of the general population.

There were a total of 18 live births. Fourteen of these were term births and four were preterm births. There were nine vaginal births and nine cesarean deliveries.

Of note, there were three cases of abnormal placental development. This was “unexpected,” the investigators say. “Although ours is a small study, the number of cases of abnormal placentation seems unusually elevated,” they write.

Therefore, women who become pregnant after UAE should be followed closely, Pron’s group cautions.

SOURCE: Obstetrics and Gynecology, January 2005.

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