No major pregnancy complications seen after fibroid ablation

For pregnancies occurring after transvaginal radiofrequency ablation of leiomyomas, the outcomes appear to be similar to pregnancies in the general population, with no reports of uterine rupture, placental abruption, or foetal growth restriction, according to a study.

For the study, researchers looked at the medical records of 226 pregnant patients (mean age 37.4 years) who previously underwent transvaginal radiofrequency ablation of leiomyomas.

The median leiomyoma volume was 52.4 mL before transvaginal radiofrequency ablation. After the procedure, the median volume reduction was 49.4 percent at 6 months and 69.8 percent at 12 months. The median interval time from transvaginal radiofrequency ablation to pregnancy was 9.3 months.

Pregnancy occurred spontaneously in 78 patients (34.5 percent) and was achieved through assisted reproductive technologies in 148 (65.5 percent). Miscarriage occurred in 15.9 percent of patients, premature delivery (before 37 weeks of gestation) in 4.1 percent, and pre-eclampsia in 4.3 percent.

Placenta accreta was documented in a patient with a history of open myomectomy. Apart from this, no instances of uterine rupture, placental abruption, or foetal growth restriction were reported.

Of the patients, 26.4 percent gave birth by caesarean section, while the remaining had normal spontaneous vaginal deliveries. Patients with larger leiomyomas (volume >58.6 mL) notably experienced a longer delay between transvaginal radiofrequency ablation and pregnancy (p<0.05). Furthermore, miscarriage rate increased when the interval time to pregnancy was shorter than 5.7 months (p<0.05).