A combination of laparoscopy and bilateral uterine artery occlusion for the treatment of type II cesarean scar pregnancy: a retrospective analysis.

OBJECTIVE: We investigated the efficacy of a combination of laparoscopy and bilateral uterine artery occlusion (BUAO) for the treatment of type II cesarean scar pregnancy (CSP). METHODS: Patients with type II CSP underwent laparoscopy + bilateral uterine artery embolization (control group) or laparoscopy + BUAO (study group). Data regarding the duration of surgery, intraoperative hemorrhage, postoperative complications, the duration of the hospital stay, and the costs of hospitalization were retrospectively collected. One year later, the time to the return of the ß-human chorionic gonadotropin (ß-hCG) concentration to normal and to the return of menstruation were compared. RESULTS: The duration of surgery, time to the return of menstruation, and incidence of postoperative complications in the study group were significantly less than in the control group, but there was no significant difference in the time for ß-hCG to return to normal or the volume of intraoperative hemorrhage. The duration of hospitalization and costs for the control group were higher than those for the study group. CONCLUSION: Laparoscopy in combination with BUAO is associated with minimal trauma, rapid recovery, a short duration of surgery, low cost of hospitalization, and a low postoperative complication rate. Thus, it represents a useful new surgical treatment for type II CSP.

Pregnancy cases after embolization of uterine fibroids / Монголын Анагаах Ухаан

INTRODUCTION:Uterine leiomyoma occurs with broad range of 20-50% among reproductive aged women. It takessecond place of all women’s genital diseases that cause abnormal menstrual bleeding. Leiomyomadependent surgical frequency such as hysterectomy is around up to 80, 6%. Lately uterine fibroidembolization treatment is highly effective, less painful, and more rapid recovery, most importantlykeeping organ while maintaining the reproductivity, is successfully entered in practice. We successfullyperformed 40 cases first time in Mongolia and 8 of them conceived naturally after treatment.GOAL:To determine if arterial embolization in women with uterine fibroids (leiomyomata) is an effectivemethod to keep their reproductive organ intact.OBJECTIVES:• To study pregnancy cases in women who had uterine fibroid embolization• To monitor and determine the features of course of pregnancy and childbirth.• To evaluate uterine fibroids.MATERIALS AND METHODS:The study was conducted in 2009-2012. A total of forty women between 23-50 years of age,diagnosed with symptomatic uterine fibroid that received embolization treatment of dominatingarterial blood vessel feeding the uterine fibroids were involved in the study. Eight of the forty womenwho conceived naturally were selected for the study. The study focused on monitoring the course oftheir pregnancy and delivery and its outcome.RESULTS:Among 40 women who underwent bilateral uterine artery embolization, 31 (75.5%) were seeking tobecome pregnant, and 8 of the 31 (25, 8%) became pregnant, four having been nulliparous. Onepatient had two pregnancies. All 8 pregnancies were spontaneous. The mean time from embolizationto conception was 12±3, 5 months (range, 6-27 months). Three medical terminations occurred. Theother 5 pregnancies went to term; one pregnancy had to be terminated pre-term due to placentapraevia. 60% experienced threatened abortion and 1 case with advanced age mother complicatedwith mild preeclampsia. 62,5% of the women’s pregnancy ended with childbirth, of which one woman(20%) had vaginal delivery and the remaining four pregnancies (80%) ended with C-section. On anaverage, post-treated uterine fibroids decreased in volume by 94% in comparison to pre-treateduterine fibroids in the patients who became pregnant. All of the neonates were healthy with Apgarscores greater than8. The mean weight of the neonates was 3,189± 200 g (range, 2,100–3,800 g). One neonate waspreterm due to placenta praevia (2,100 g).CONCLUSION:1. Of the forty women that received arterial embolization treatment with uterine fibroid, thirty one(75, 5%) women desired to keep their uterine for further reproduction, of which eight women (25,8% of the patients) between the ages of 23-42 years (mean age=35) conceived naturally. Arterialembolization to treat women with uterine fibroids is an effective method for women who wish to keeptheir reproductive organ intact to conceive and reproduce.2. 60 percent of the women who conceived experienced threatened abortion and 20 percent of thewomen’s pregnancy had to be terminated pre-term due to placenta praevia. 62,5 percent of thewomen’s pregnancy ended with childbirth, of which one woman (20%) had vaginal delivery and theremaining four pregnancies (80%) ended with C-section.3. On an average, post-treated uterine fibroids decreased in volume by 94% in comparison to pretreateduterine fibroids.