| July 2005 · Vol. 17, No. 7 Case-Based Learning
Uterine artery embolization for abnormal bleeding
How to treat women with fibroids or adenomyosis, the most common myometrial causes of premenopausal abnormal uterine bleeding.
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IN THIS ARTICLE
DISCHARGE INSTRUCTIONS WALLET INFO-CARD When to call your doctor
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Fast Track
The ideal patient is premenopausal, has symptomatic fibroids and/or adenomyosis, has failed therapy, and wants or needs to avoid surgery
MRI enables classification of masses as submucosal, intramural, or subserosal
The patient should have a normal Pap test (in the past year) and should undergo endometrial biopsy to rule out cancer
Abnormal bleeding improves in 77% to 90% of fibroid cases, and bulk-related symptoms resolve in 86% to 91%
Of 400 consecutive fibroid patients:
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1.25% serious complications
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5% periprocedural morbidity
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0 deaths or major permanent injuries
Successful pregnancies have followed UAE, but so have higher rates of cesarean, miscarriage, and preterm birth
UAE advantages: less invasive, local anesthesia plus conscious sedation, virtually no blood loss, no adhesions
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Ducksoo
Kim,
MD;
Director of Cardiovascular and Interventional Radiology Professor of Radiology and Surgery University of Massachusetts Medical Memorial Health Care Worcester, Mass Stephen
D.
Baer,
MD, MPHInstructor of Obstetrics and Gynecology, Harvard Medical School, Staff ObGyn at Brigham and Women’s Hospital, Quincy Medical Center, Caritas Carney Hospital, Caritas St. Elizabeth Medical Center, and Beth Israel Deaconess Medical Center, Boston, Mass
LISA’S CASE
Ablation fails to ease symptoms
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