The Outcomes of Interventional Radiology in Obstetrics and Gynecology at a University Hospital-A 10-year overview
Article Sidebar
-
Radiology, interventional, obstetrics, gynecology, complications, uterine artery embolization
Abstract
Objectives: This study aimed to assess the outcomes of interventional radiology (IR) in obstetrics and gynecology patients.
Material and methods: A retrospective cohort study was conducted between 1st of January 2010 to 31st of December 2019 among women (≥ 18 years old) who had a radiological intervention for an obstetrical or gynecological reason.
Results: Out of the 50 pregnant women, 11 (22%) underwent uterine arteries embolization (UAE), 36 (72%) underwent prophylactic internal iliac arteries (IIA) balloon occlusion, one (2%) underwent inferior vena cava (IVC) filter and two (4%) underwent renal biopsies. The success rate of UAE procedures was 100% and there were no further procedures. The success rate of IIA balloon occlusion was 50%, nine (25%) patients needed an emergency hysterectomy, and one (2.8%) patient required another embolization procedure. The success rate of IVC filter and renal biopsies was 100% with no need for further management. A total of 35 women with gynecological conditions were included in the study. The indications for IR were 29 (83%) for uterine fibroids, two (6%) for ovarian mass biopsies and one (3%) case each for ectopic pregnancy, vaginal varicocele, pelvic pseudoaneurysm and uterine leiomyosarcoma. The most common intervention was UAE, 77% (n=27). The overall success rate for all procedures was 80% (n=28). There were Seven (20%) cases that required further alternative intervention which were medical or surgical interventions.
Conclusion: This study showed a high success rate of the interventional radiological procedures with minor complications noted. This study built the base for further prospective multicenter studies.
Full text article
References
Ganeshan A, Nazir SA, Hon LQ, Upponi SS, Foley P, Warakaulle DR et al. The role of interventional radiology in obstetric and gynaecology practice, European Journal of Radiology 2010, 73(2): 404–411. https://doi.org/10.1016/j.ejrad.2008.11.020.
Khan A, Shehmar M, Gupta J. Uterine fibroids : current perspectives, International Journal of Women’s Health 2014, 6: 95–114. https://doi.org/10.2147/IJWH.S51083.
Alkema L, Chou D, Hogan D, Zhang S, Moller A B, Gemmill A et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group Lancet 2016387(10017):462–474. Doi: 10.1016/S0140-6736(15)00838-7.
Katz MD, Sugay SB, Walker DK, Palmer SL, Victoria Marx M. Beyond hemostasis: Spectrum of gynecologic and obstetric indications for transcatheter embolization, Radiographics 2012, 32(6): 1713–1731. https://doi.org/10.1148/rg.326125524.
Lindquist JD and Vogelzang RL. Pelvic Artery Embolization for Treatment of Postpartum Hemorrhage, Seminars in Interventional Radiology 2018, 35(1): 41–47. https://doi.org/10.1055/s-0038-1636520.
Soyer P, Barat M, Loffroy R, Barral M, Dautry R, Vidal V et al. The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences, Quantitative Imaging in Medicine and Surgery 2020, 10(6): 1370–1391. https://doi.org/10.21037/QIMS-20-548.
Registersign B, Brought BH, Download O, Share P, Advanced E, Access R. Outline 1., clinical radiology 2014, 69(8): 345–351.
Bouvier A, Sentilhes L, Thouveny F, Bouet PE, Gillard P, Willoteaux S et al. Planned caesarean in the interventional radiology cath lab to enable immediate uterine artery embolization for the conservative treatment of placenta accreta, Clinical Radiology 2012, 67(11): 1089–1094. https://doi.org/10.1016/j.crad.2012.04.001.
Harris S, Velineni R, Davies A. Inferior Vena Cava Filters in Pregnancy: A Systematic Review. J Vasc Interv Radiol. 2016 Mar;27(3):354-60.e8. doi: 0.1016/j.jvir.2015.11.024.
Singhal S, Singh A, Raghunandan C, Gupta U, Dutt S. Uterine Artery Embolization: Exploring New Dimensions in Obstetric Emergencies, Oman Medical Journal 2014, 29(3): 217–219. https://doi.org/10.5001/omj.2014.53.
Gupta JK, Sinha A, Lumsden MA, HickeyM. Uterine artery embolization for symptomatic uterine fibroids (Review), Cochrane Database of Systematic Reviews 2014, (12). https://doi.org/10.1002/14651858.CD005073.pub4.www.cochranelibrary.com.
Manyonda I, Belli AM, Lumsden MA, Moss J, Mckinnon W, Middleton LJ et al. Uterine-Artery Embolization or Myomectomy for Uterine Fibroids, The New England Journal of Medicine 2020, 440–451. https://doi.org/10.1056/NEJMoa1914735.
Singh SS and Belland L. Contemporary management of uterine fibroids : focus on emerging medical treatments Review Contemporary management of uterine fibroids : focus on emerging medical treatments, Current Medical Research and Opinion 2015, 31: 1–12. https://doi.org/10.1185/03007995.2014.982246.
O’Sullivan AK, Thompson D, Chu P, Lee DW, Stewart EA, Weinstein MC. Cost-effectiveness of magnetic resonance guided focused ultrasound for the treatment of uterine fibroids, International Journal of Technology Assessment in Health Care 2009, 25(1): 14–25. https://doi.org/10.1017/S0266462309090035.
Ching KC. and Sumkin JH. Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal Ultrasound Guidance, Obstetrics and Gynecology International 2015. Hindawi Publishing Corporation, 2015: 10–13. https://doi.org/10.1155/2015/283576.
Myers, TT. Uterine artery embolization for postpartum hemorrhage, Journal of Radiology Nursing 2016, 35(2): 142–145. https://doi.org/10.1016/j.jradnu.2016.01.008.
Nankali A, Salari N, Kazeminia M, Mohammadi M, Rasoulinya S, Hosseinian-Far M. The effect prophylactic internal iliac artery balloon occlusion in patients with placenta previa or placental accreta spectrum: a systematic review and meta‐analysis. Reproductive Biology and Endocrinology 2021,19:40. https://doi.org/10.1186/s12958-021-00722-3.
Zhang XQ, Chen XT, Zhang YT, Mai CX. The Emergent Pelvic Artery Embolization in the Management of Postpartum Hemorrhage: A Systematic Review and Meta-analysis. Obstet Gynecol Surv. 2021;76(4):234–44.
Aoki M, Tokue H, Miyazaki M, Shibuya K, Hirasawa S, Oshima K. Primary postpartum hemorrhage: outcome of uterine artery embolization. Br J Radiol. 2018; 91(1087): 20180132. doi: 10.1259/bjr.20180132.
Mondelli B, Walker WJ, Dhanoya T, Morton K. Uterine Fibroid Embolization in a Series of Women Older Than 50 Years: An Observational Study. Women’s Health Reports 2022, 3.1 DOI: 10.1089/whr.2021.0057.
Angileri SA, Mailli L, Raspanti C, Lerardi AM, Carrafiello G, Belli AM. Prophylactic occlusion balloon placement in internal iliac arteries for the prevention of postpartum haemorrhage due to morbidly adherent placenta: short term outcomes. Radiol med 122, 798–806, 2017. https://doi.org/10.1007/s11547-017-0777-z.
Manyonda IT, Bratby M, Horst JS, Banu N, Gorti M, Belli AM. Uterine Artery Embolization versus Myomectomy : Impact on Quality of Life-Results of the FUME
(Fibroids of the Uterus : Myomectomy versus Embolization ) Trial 2011, 35(3): 530–536. https://doi.org/10.1007/s00270-011-0228-5.
Davis MR, Soliman AM, Castelli-haley J, Snabes MC, Surrey ES. Original Articles, Journal of Women’s Health 2018, 27(10). https://doi.org/10.1089/jwh.2017.6752.
Broder MS, Goodwin S, Chen G, Tang LJ, Costantino MM, Nguyen MH et al. Comparison of Long-Term Outcomes of Myomectomy and Uterine Artery Embolization, Obstet Gynecol 2002, 100(5): 864–868.
Bonduki CE, Feldner PC, Silva J, Castro RA, Sartori MGF, Gira MJBC. Pregnancy after uterine arterial embolization, SciELO 2011, 66(5): 807–810. https://doi.org/10.1590/S1807-59322011000500016.
Homer H. and Saridogan E. Uterine artery embolization for fibroids is associated with an increased risk of miscarriage, Fertility and Sterility 2010, 94(1): 324–330. https://doi.org/10.1016/j.fertnstert.2009.02.069.
Authors
Copyright (c) 2023 Journal of Current Medical Research and Opinion
This work is licensed under a Creative Commons Attribution 4.0 International License.