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Grand Rounds

High-Intensity Ultrasound for Fibroids – What are the Pregnancy Outcomes?

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BACKGROUND AND PURPOSE:

  • Ultrasound guided high-intensity focused ultrasound (HIFU) is an effective, non-invasive treatment for fibroids, but fertility and pregnancy effects are not well characterized
  • Zou et al. (BJOG, 2017) evaluated the effect of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids on pregnancy

METHODS:

  • Retrospective Observational study (2011-2016)
  • Cohort: Patients with uterine fibroids who wished to become pregnant and subsequently underwent a HIFU procedure

RESULTS:

  • Data from 78 women were evaluated
  • Total pregnancy rate was 19.2% (78/406) and average time to pregnancy was 5.6 months
    • Out of 80 pregnancies, 4 were IVF
  • Of 78 patients who became pregnant
    • 9 had complicated primary or secondary infertility before the HIFU treatment
    • 13 had at least two miscarriages
  • After the HIFU treatment, the average time to pregnancy was 5.6 ± 2.7 months
  • There were 15 vaginal deliveries and 56 cesarean sections
    • Majority of cesarean sections were for social reasons
    • No evidence that HIFU affects mode of delivery
  • 68 pregnancies were term and 3 cases were preterm (uncertain fetal status, PROM and decreased AFV), with an average gestational age of 38.1 weeks.
  • There were 3 miscarriages (1 with low progesterone and 2 unexplained)
  • There were no cases of fetal anomalies or perinatal/postpartum complications
  • There were no cases of abnormal placentation or uterine rupture

CONCLUSION:

  • The researchers did not find increase pregnancy complications with HIFU
  • HIFU may be an approach to treat fibroids in women who are still interested in pregnancy, including those who have a history of infertility

Learn More – Primary Sources:

Pregnancy outcomes in patients with uterine fibroids treated with ultrasound-guided high-intensity focused ultrasound

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Related ObG Topics:

Are Fibroids Associated with Miscarriage?
Uterine Artery Embolization or Focused Ultrasound for Uterine Fibroids?
From Genetics to Soybeans: What are the Risk Factors for Uterine Fibroids?

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