Stojnev Dzordze, Yordanov Angel
Department of Obstetrics and Gynaecology, UMHAT Medica Ruse, Ruse, Bulgaria.
Department of Gynecologic Oncology, Medical University Pleven, Pleven, Bulgaria.
Prz Menopauzalny. 2025 Jun;24(2):143-147. doi: 10.5114/pm.2025.152138. Epub 2025 Jun 17.
Uterine artery embolization (UAE) is a minimally invasive method that has been proven to be an effective alternative to hysterectomy and myomectomy for the treatment of symptomatic fibroids, though its impact on fertility and obstetric outcomes remains controversial. This case report presents a 31-year-old nulliparous woman with a history of fibroid-enlarged uterus (about the size of a 16-20-week pregnancy), who underwent UAE treatment, became pregnant, and delivered a healthy child by cesarean section. At the age of 35, a second UAE was performed due to recurrence of symptoms, followed by a successful conception and delivery of a second child. This report explores the clinical course, management strategies and the role of a multidisciplinary approach in achieving successful outcomes. Although substantial evidence has accumulated in the literature about the safety and effectiveness of UAE as a non-surgical option for uterine fibroids treatment, this procedure still raises questions about its impact on future fertility and obstetric outcomes, including the risk of miscarriage, placenta previa, and preterm delivery. Uterine artery embolization is a promising minimally invasive alternative to myomectomy for women with fibroids who want to preserve their fertility. The present case demonstrates that successful conception and childbirth are possible when patients undergo close follow-up and individualized management.
子宫动脉栓塞术(UAE)是一种微创方法,已被证明是治疗有症状子宫肌瘤的子宫切除术和肌瘤切除术的有效替代方法,尽管其对生育能力和产科结局的影响仍存在争议。本病例报告介绍了一名31岁未生育的女性,其有子宫肌瘤导致子宫增大(约16 - 20周妊娠大小)的病史,接受了UAE治疗,随后怀孕并通过剖宫产分娩了一个健康的婴儿。35岁时,由于症状复发进行了第二次UAE,之后成功受孕并分娩了第二个孩子。本报告探讨了临床过程、管理策略以及多学科方法在取得成功结局中的作用。尽管文献中已积累了大量关于UAE作为子宫肌瘤非手术治疗选择的安全性和有效性的证据,但该手术仍引发了关于其对未来生育能力和产科结局影响的问题,包括流产、前置胎盘和早产风险。对于希望保留生育能力的子宫肌瘤女性,子宫动脉栓塞术是一种有前景的替代肌瘤切除术的微创方法。本病例表明,当患者接受密切随访和个体化管理时,成功受孕和分娩是可能的。