Mills Ariana C, Marinelli Brett, Klein Emma D, Garcia-Reyes Kirema, Shilo Dan, Nowakowski Scott, Patel Rahul, Patel Rajesh, Kim Edward, Fischman Aaron, Bishay Vivian, Loudon Holly, Stone Joanne, Lookstein Robert
Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York.
Biomedical Engineering and Imaging Institute, Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Am J Perinatol. 2024 May;41(S 01):e1257-e1263. doi: 10.1055/s-0043-1761917. Epub 2023 Mar 1.
This study aimed to investigate pregnancy rate, pregnancy outcomes, and resumption of menses after transcatheter arterial embolization (TAE) for obstetric hemorrhage (OH).
Sixty-seven patients who underwent TAE for OH from 2006 to 2020 within an urban, multihospital health care system were identified retrospectively. Selected patients were interviewed by phone to complete a survey with a primary outcome of self-reported pregnancy in those seeking pregnancy. Secondary outcomes included pregnancy outcomes and resumption of menses. Univariate testing of association of pregnancy and miscarriage rate with embolic agent was performed using Fisher's exact test.
Thirty-three of 50 patients (66%) meeting the inclusion criteria completed the survey on fertility, a median of 47 (range, 13-123) months after TAE for OH. Of the 13 patients who attempted pregnancy, there was a pregnancy rate of 77% and miscarriage rate of 38%. Those who delivered live newborns conceived spontaneously, carried to term, and delivered a healthy newborn via cesarean section at a weight appropriate for gestational age. Thirty (91%) patients resumed menstruation, and the majority with unchanged frequency. Most patients underwent bilateral uterine artery embolization with radial artery access (54%). The most common embolic agents used were gelfoam only (30%) and glue only (24%). There was no statistically significant association between embolic agent and pregnancy or miscarriage rate.
Spontaneous pregnancy with live birth and resumption of menses can occur in a majority of patients after TAE for OH.
· Most patients who attempted pregnancy after TAE for OH achieved pregnancy.. · Most patients who became pregnant conceived spontaneously and delivered healthy newborns at term.. · Most patients resumed menstruation after TAE for OH.. · There was no significant association between type of embolic and pregnancy or miscarriage rate..
本研究旨在调查经导管动脉栓塞术（TAE）治疗产科出血（OH）后的妊娠率、妊娠结局及月经恢复情况。
回顾性确定了2006年至2020年在城市多医院医疗系统中接受TAE治疗OH的67例患者。通过电话采访选定患者，以完成一项调查，主要结局是寻求妊娠者自我报告的妊娠情况。次要结局包括妊娠结局和月经恢复情况。使用Fisher精确检验对妊娠和流产率与栓塞剂的相关性进行单因素检验。
50例符合纳入标准的患者中有33例（66%）完成了生育情况调查，在TAE治疗OH后中位时间为47（范围13 - 123）个月。在13例尝试妊娠的患者中，妊娠率为77%，流产率为38%。自然受孕并足月分娩活产新生儿的患者通过剖宫产分娩了一名体重适合孕周的健康新生儿。30例（91%）患者恢复月经，且大多数月经频率未变。大多数患者采用经桡动脉途径进行双侧子宫动脉栓塞（54%）。最常用的栓塞剂分别是单纯明胶海绵（30%）和单纯胶水（24%）。栓塞剂与妊娠或流产率之间无统计学显著相关性。
大多数OH患者在接受TAE治疗后可自然受孕并活产，且月经恢复。
· 大多数OH患者在TAE治疗后尝试妊娠并成功妊娠。· 大多数妊娠患者自然受孕并足月分娩健康新生儿。· 大多数OH患者在TAE治疗后恢复月经。· 栓塞类型与妊娠或流产率之间无显著相关性。
