Fertility, Pregnancy, and Clinical Outcomes after Uterine Arteriovenous Malformation Management

Delplanque, Sophie; Lous, Maëla Le; Proisy, Maïa; Joueidi, Yolaine; Bauville, Estelle; Rozel, Céline; Beraud, E; Bruneau, Bertrand; Lévèque, Jean; Lavoué, Vincent; Timoh, Krystel Nyangoh

doi:10.1016/j.jmig.2018.05.001

Cited by 25 publications

(27 citation statements)

References 31 publications

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“…UAE is a minimally invasive interventional treatment. It can be used as an auxiliary treatment for various acute and chronic genital bleeding diseases, and is also commonly used in the treatment of uterine leiomyoma [9] and uterine arteriovenous malformation [10]. The technique is often used in CSP patients before surgery to prevent intraoperative bleeding, with good haemostatic effects [11,12],however, its effect on postoperative fertility remains unclear.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Prophylactic Uterine Artery Embolisation On Reproductive Outcomes In Caesarean Scar Pregnancy Patients: A Propensity Score-Matched Study

Wang

Zhang³

et al. 2021

Preprint

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Purpose: This study aimed to investigate the effect of prophylactic uterine artery embolisation (UAE) on reproductive outcomes in caesarean scar pregnancy (CSP) patients.Methods: Clinical data of CSP patients diagnosed at Shengjing Hospital of China Medical University from January 2014 to December 2019 were collected. According to inclusion and exclusion criteria, 181 patients with reproductive needs were selected and divided into UAE group (n = 51) and non-UAE group (n = 130) according to whether the patient received preventive UAE before their hysteroscopic or laparoscopic operation. The basic characteristics and pregnancy outcomes of individuals of the groups were compared, and propensity score matched (PSM) analysis was used to produce 37 matched pairs.Results: Before PSM, the UAE group had a thinner muscle layer, larger mass size, and higher serum human chorionic gonadotropin level than the non-UAE group. The pregnancy rate and live birth rate of the UAE group were 54.9% and 61.9%, respectively, which were lower than those of the non-UAE group (61.5% and 66.7%), but no statistical differences were observed. Post-PSM, no significant differences between basic characteristics of the groups were observed. The pregnancy rate of the UAE group was 51.4%, lower than that of the non-UAE group (73.0%). The live birth rate of the UAE group was 64.3%, also lower than that of the non-UAE group (72.7%); however, the difference was not statistically significant.Conclusion: Prophylactic UAE is a safe and effective adjuvant treatment for CSP, and has no significant effect on subsequent pregnancy and live birth rates.

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Section: Discussionmentioning

confidence: 99%

The Effect of Prophylactic Uterine Artery Embolisation On Reproductive Outcomes In Caesarean Scar Pregnancy Patients: A Propensity Score-Matched Study

Wang

Zhang³

et al. 2021

Preprint

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“…The majority of women with this condition are of childbearing age, and fertility potential is an important treatment consideration. Uterine artery embolization initially showed promise and continues to be used in many centers despite failure rates ranging between 17% and 60% and reports of poor future pregnancy rates and outcomes [1,5,9]. Some successes with a variety of conservative treatment options have been reported, including the use of danazol, methylergonovine maleate, oral contraceptives and gonadotropin-releasing hormone agonist [4].…”

Section: Discussionmentioning

confidence: 99%

“…Historically, the treatment of uterine AVMs was hysterectomy when medical management of profuse bleeding failed [4,5]. Uterine artery embolization (UAE) continues to be used as the initial treatment in many centres despite inconsistent success rates and potentially detrimental effects on future fertility and pregnancy success [1,5,9]. Medical management has shown potential success in reports, especially with a combination of GnRH agonist, aromatase inhibitor and antifibrinolytic [1,10].…”

Section: Introductionmentioning

confidence: 99%

Resolution of Post-Molar Pregnancy Uterine Arteriovenous Malformation Following Treatment with GnRH Agonist Concomitantly with an Aromatase Inhibitor and Tranexamic Acid

Haakman¹,

Liang²,

Alzawawi³

et al. 2020

AJCR

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Background: Acquired uterine arteriovenous malformations (AVM) are a rare but potentially serious condition that can result in severe bleeding. Rarely, uterine AVM can occur following a complete molar pregnancy. Resolution of AVMs has been reported recently with conservative management using a combination of Gonadotropin-Releasing Hormone (GnRH) agonist, an aromatase inhibitor and tranexamic acid. This treatment has not previously been reported in a patient with AVM post molar gestation. Case Presentation: A 23-year-old woman was diagnosed with a large uterine arteriovenous malformation following a suction curettage for a molar pregnancy. Complete resolution of the lesion on imaging was seen after six weeks of medical management. Conclusion: A uterine arteriovenous malformation can develop in a patient post complete molar pregnancy and can be successfully treated with medical management.

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“…If symptoms persist and the disease recurs, reembolizationor radical surgery should be considered. [87][88][89][90][91]…”

Section: Follow-upmentioning

confidence: 99%

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management

et al. 2021

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Uterine arteriovenous malformation (UAVM) is a rare condition and is classified as either congenital or acquired UAVM. Patients with UAVMs usually experience miscarriages or recurrent menorrhagia. Ultrasound is used for the initial estimation of UAVMs. Computed tomography and magnetic resonance imaging are noninvasive and valuable methods that provide good compatibility with digital subtraction angiography to support the diagnosis and treatment of UAVM. Timely diagnosis is crucial to provide appropriate treatment for alleviating complications. This article presents a pictorial and literature review of the current evidence of the diagnosis and management of UAVM.

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Fertility, Pregnancy, and Clinical Outcomes after Uterine Arteriovenous Malformation Management

Abstract: UAE for UAVM is an effective and safe technique. It does not impair fertility, and obstetric prognosis is good.

Cited by 25 publications

References 31 publications

The Effect of Prophylactic Uterine Artery Embolisation On Reproductive Outcomes In Caesarean Scar Pregnancy Patients: A Propensity Score-Matched Study

The Effect of Prophylactic Uterine Artery Embolisation On Reproductive Outcomes In Caesarean Scar Pregnancy Patients: A Propensity Score-Matched Study

Resolution of Post-Molar Pregnancy Uterine Arteriovenous Malformation Following Treatment with GnRH Agonist Concomitantly with an Aromatase Inhibitor and Tranexamic Acid

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management

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