Human Reproduction, Vol. 18, No. 5, 1077-1081,
May 2003
© 2003 European Society of Human Reproduction and Embryology
Pregnancy following treatment of symptomatic myomas with laparoscopic bipolar coagulation of uterine vessels
1 Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, 2 Institute of Clinical Medicine, National Yang-Ming University, Taipei and 3 Department of Obstetrics and Gynecology, Taipei Medical University Hospital and Taipei Medical University, Taiwan
4 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan. e-mail: chenyj{at}vghtpe.gov.tw
BACKGROUND: Laparoscopic bipolar coagulation of uterine vessels (LBCUV) has been employed for women with symptomatic uterine myomas, but its effect on subsequent pregnancy has not been characterized. METHODS: Four-hundred and twenty-three women entered the study between March 1999 and December 2001. Of these, 142 women (33.6%) were under the age of 40 years at the time of LBCUV, 36 of whom (36/142, 25.3%) were sexually active without contraception. In a prospective study of 142 patients (<40 years old) undergoing LBCUV for symptomatic myomas, 15 women became pregnant (17 total pregnancies) and were evaluated by physical and ultrasound examinations. RESULTS: The volume of the dominant myoma was 117.4 ± 118.4 and 36.8 ± 56.8 cm3 before and after LBCUV respectively. Volume of the dominant myoma after pregnancy was 46.2 ± 76.7 cm3 (mean ± SD). There was a significant difference in myoma volume before and after LBCUV (P = 0.002), but no significant difference in myoma volume when comparing post-partum size with post-LBCUV size (P = 0.269). Pregnancy outcomes included seven miscarriages in the first trimester and one premature rupture of membrane (PPROM). Although the other pregnancies were regarded as uncomplicated, only two women were delivered of normal neonates as the other seven pregnancies were terminated secondary to patient request. CONCLUSIONS: The pregnancy and term pregnancy rates in sexually active women without contraception were 41.6% (15/36) and 5.6% (2/36) respectively. Because a relatively high rate (7/17, 41.2%) of early miscarriages was observed, we recommend that this procedure be employed only for women who do not desire additional children.
Key words: laparoscopic bipolar coagulation of uterine vessels/laparoscopic surgery/pregnancy/myoma
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