Ruiz Labarta Francisco Javier, Pintado Recarte María Pilar, González Leyte Manuel, Arribas Coral Bravo, Álvarez Luque Arturo, Cuñarro López Yolanda, García-Montero Cielo, Fraile-Martinez Oscar, Ortega Miguel A, De León-Luis Juan A
Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain.
Maternal Fetal Medicine Research Group, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain.
J Pers Med. 2022 Jul 1;12(7):1098. doi: 10.3390/jpm12071098.
Uterine Arteriovenous Malformation (UAVM) is a rare but life-threating cause of uterine bleeding. The clinical management of this condition is challenging, and there is a need to describe the most adequate approach for these patients. Uterine artery embolization (UAE) is the most widely-published treatment in the literature in recent years, although there is a need to update the evidence on this treatment and to compare it with other available therapies. Thus, the objective of this systematic review is to quantify the efficacy of UAE of UAVM. In addition, we evaluated the clinical context of the patients included, the treatment complications, and the pregnancy outcomes after UAE. With this goal in mind, we finally included 371 patients spread over all continents who were included in 95 studies. Our results show that, similar to other medical therapies, the global success rate after embolization treatment was 88.4%, presenting a low risk of adverse outcomes (1.8%), even in women with later pregnancy (77% had no complications). To date, this is the largest systematic review conducted in this field, although there are still some points to address in future studies. The results obtained in our study should be outlined in UAE protocols and guidelines to aid in clinical decision-making in patients with UAVM.
子宫动静脉畸形（UAVM）是一种罕见但危及生命的子宫出血原因。这种疾病的临床管理具有挑战性，需要描述针对这些患者的最适当治疗方法。子宫动脉栓塞术（UAE）是近年来文献中发表最多的治疗方法，尽管需要更新关于这种治疗的证据并将其与其他可用疗法进行比较。因此，本系统评价的目的是量化UAVM的UAE疗效。此外，我们评估了纳入患者的临床情况、治疗并发症以及UAE后的妊娠结局。出于这个目的，我们最终纳入了分布在各大洲的371例患者，这些患者来自95项研究。我们的结果表明，与其他医学疗法类似，栓塞治疗后的总体成功率为88.4%，不良结局风险较低（1.8%），即使是晚期妊娠的女性（77%无并发症）。迄今为止，这是该领域进行的最大规模的系统评价，尽管未来研究仍有一些问题需要解决。我们研究中获得的结果应纳入UAE方案和指南，以帮助指导UAVM患者的临床决策。
