Obstetric Outcomes of Pregnancy After Uterine Artery Embolization

Mariko Jitsumori,1,* Shinya Matsuzaki,1,* Masayuki Endo,1 Takeya Hara,1 Takuji Tomimatsu,1 Satoko Matsuzaki,2 Tatsuya Miyake,1 Tsuyoshi Takiuchi,1 Aiko Kakigano,1 Kazuya Mimura,1 Eiji Kobayashi,1 Yutaka Ueda,1 Tadashi Kimura1 1Department of Obstetrics and Gynecology, Osaka University Graduate School...

Full description

Bibliographic Details
Main Authors: Jitsumori M, Matsuzaki S, Endo M, Hara T, Tomimatsu T, Miyake T, Takiuchi T, Kakigano A, Mimura K, Kobayashi E, Ueda Y, Kimura T
Format: Article
Language:English
Published: Dove Medical Press 2020-03-01
Series:International Journal of Women's Health
Subjects:
Online Access:https://www.dovepress.com/obstetric-outcomes-of-pregnancy-after-uterine-artery-embolization-peer-reviewed-article-IJWH
_version_ 1811327517061021696
author Jitsumori M
Matsuzaki S
Endo M
Hara T
Tomimatsu T
Matsuzaki S
Miyake T
Takiuchi T
Kakigano A
Mimura K
Kobayashi E
Ueda Y
Kimura T
author_facet Jitsumori M
Matsuzaki S
Endo M
Hara T
Tomimatsu T
Matsuzaki S
Miyake T
Takiuchi T
Kakigano A
Mimura K
Kobayashi E
Ueda Y
Kimura T
author_sort Jitsumori M
collection DOAJ
description Mariko Jitsumori,1,* Shinya Matsuzaki,1,* Masayuki Endo,1 Takeya Hara,1 Takuji Tomimatsu,1 Satoko Matsuzaki,2 Tatsuya Miyake,1 Tsuyoshi Takiuchi,1 Aiko Kakigano,1 Kazuya Mimura,1 Eiji Kobayashi,1 Yutaka Ueda,1 Tadashi Kimura1 1Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan; 2Department of Obstetrics and Gynecology, Otemae Hospital, Osaka, Japan*These authors contributed equally to this workCorrespondence: Shinya Matsuzaki; Aiko KakiganoDepartment of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanTel +81-6-6879-3355Fax +81-6-6879-3359Email zacky@gyne.med.osaka-u.ac.jp; ai-kaki@gyne.med.osaka-u.ac.jpBackground: Uterine artery embolization (UAE) is used to treat severe postpartum hemorrhage (PPH). According to a few studies, UAE for PPH was associated with preterm birth, fetal growth restriction (FGR), and placenta accreta spectrum (PAS) in subsequent pregnancies. These previous studies, however, lacked controls, and to the best of our knowledge, no systematic literature reviews have been conducted thus far. We report the results of our retrospective case–control study of pregnancies after UAE at a single center and include a literature review to evaluate the risk of PAS in pregnancies after UAE.Methods: We retrospectively reviewed data from deliveries at our hospital between January 2012 and October 2017. We divided the delivery data into cases with previous UAEs performed for PPH (the post-UAE group) and those without UAEs (the non-UAE group, which included women without previous PPH). We defined PAS as cases in which hysterectomy was performed and pathological examination confirmed the diagnosis. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs).Results: We used data from 3155 patients in this study, of whom 16 patients had undergone UAE (post-UAE group) and 3139 had not (non-UAE group). We found no differences between the groups in terms of frequency of preterm births (12.5% versus 14.2%, respectively; OR, 0.863; 95% CI, 0.218 to 3.414; P = 0.84) or FGR (6.2% versus 10.0%, respectively; OR, 0.602; 95% CI, 0.104 to 3.584; P = 0.61). However, cases of PAS were significantly more common in the post-UAE group (37.5%) than in the non-UAE group (1.2%; OR, 50.303; 95% CI, 17.38 to 145.592; P < 0.01).Conclusion: Our results suggest that previous UAE is a significant risk factor for PAS.Keywords: placenta accreta, placenta accreta spectrum, uterine artery embolization, postpartum hemorrhage, obstetric outcomes
first_indexed 2024-04-13T15:08:12Z
format Article
id doaj.art-b91e374a4b2a4d878a6a1e26e0c46bfe
institution Directory Open Access Journal
issn 1179-1411
language English
last_indexed 2024-04-13T15:08:12Z
publishDate 2020-03-01
publisher Dove Medical Press
record_format Article
series International Journal of Women's Health
spelling doaj.art-b91e374a4b2a4d878a6a1e26e0c46bfe2022-12-22T02:42:06ZengDove Medical PressInternational Journal of Women's Health1179-14112020-03-01Volume 1215115852321Obstetric Outcomes of Pregnancy After Uterine Artery EmbolizationJitsumori MMatsuzaki SEndo MHara TTomimatsu TMatsuzaki SMiyake TTakiuchi TKakigano AMimura KKobayashi EUeda YKimura TMariko Jitsumori,1,* Shinya Matsuzaki,1,* Masayuki Endo,1 Takeya Hara,1 Takuji Tomimatsu,1 Satoko Matsuzaki,2 Tatsuya Miyake,1 Tsuyoshi Takiuchi,1 Aiko Kakigano,1 Kazuya Mimura,1 Eiji Kobayashi,1 Yutaka Ueda,1 Tadashi Kimura1 1Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan; 2Department of Obstetrics and Gynecology, Otemae Hospital, Osaka, Japan*These authors contributed equally to this workCorrespondence: Shinya Matsuzaki; Aiko KakiganoDepartment of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanTel +81-6-6879-3355Fax +81-6-6879-3359Email zacky@gyne.med.osaka-u.ac.jp; ai-kaki@gyne.med.osaka-u.ac.jpBackground: Uterine artery embolization (UAE) is used to treat severe postpartum hemorrhage (PPH). According to a few studies, UAE for PPH was associated with preterm birth, fetal growth restriction (FGR), and placenta accreta spectrum (PAS) in subsequent pregnancies. These previous studies, however, lacked controls, and to the best of our knowledge, no systematic literature reviews have been conducted thus far. We report the results of our retrospective case–control study of pregnancies after UAE at a single center and include a literature review to evaluate the risk of PAS in pregnancies after UAE.Methods: We retrospectively reviewed data from deliveries at our hospital between January 2012 and October 2017. We divided the delivery data into cases with previous UAEs performed for PPH (the post-UAE group) and those without UAEs (the non-UAE group, which included women without previous PPH). We defined PAS as cases in which hysterectomy was performed and pathological examination confirmed the diagnosis. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs).Results: We used data from 3155 patients in this study, of whom 16 patients had undergone UAE (post-UAE group) and 3139 had not (non-UAE group). We found no differences between the groups in terms of frequency of preterm births (12.5% versus 14.2%, respectively; OR, 0.863; 95% CI, 0.218 to 3.414; P = 0.84) or FGR (6.2% versus 10.0%, respectively; OR, 0.602; 95% CI, 0.104 to 3.584; P = 0.61). However, cases of PAS were significantly more common in the post-UAE group (37.5%) than in the non-UAE group (1.2%; OR, 50.303; 95% CI, 17.38 to 145.592; P < 0.01).Conclusion: Our results suggest that previous UAE is a significant risk factor for PAS.Keywords: placenta accreta, placenta accreta spectrum, uterine artery embolization, postpartum hemorrhage, obstetric outcomeshttps://www.dovepress.com/obstetric-outcomes-of-pregnancy-after-uterine-artery-embolization-peer-reviewed-article-IJWHplacenta accretaplacenta accreta spectrumuterine artery embolizationpostpartum hemorrhageobstetric outcomes
spellingShingle Jitsumori M
Matsuzaki S
Endo M
Hara T
Tomimatsu T
Matsuzaki S
Miyake T
Takiuchi T
Kakigano A
Mimura K
Kobayashi E
Ueda Y
Kimura T
Obstetric Outcomes of Pregnancy After Uterine Artery Embolization
International Journal of Women's Health
placenta accreta
placenta accreta spectrum
uterine artery embolization
postpartum hemorrhage
obstetric outcomes
title Obstetric Outcomes of Pregnancy After Uterine Artery Embolization
title_full Obstetric Outcomes of Pregnancy After Uterine Artery Embolization
title_fullStr Obstetric Outcomes of Pregnancy After Uterine Artery Embolization
title_full_unstemmed Obstetric Outcomes of Pregnancy After Uterine Artery Embolization
title_short Obstetric Outcomes of Pregnancy After Uterine Artery Embolization
title_sort obstetric outcomes of pregnancy after uterine artery embolization
topic placenta accreta
placenta accreta spectrum
uterine artery embolization
postpartum hemorrhage
obstetric outcomes
url https://www.dovepress.com/obstetric-outcomes-of-pregnancy-after-uterine-artery-embolization-peer-reviewed-article-IJWH
work_keys_str_mv AT jitsumorim obstetricoutcomesofpregnancyafteruterinearteryembolization
AT matsuzakis obstetricoutcomesofpregnancyafteruterinearteryembolization
AT endom obstetricoutcomesofpregnancyafteruterinearteryembolization
AT harat obstetricoutcomesofpregnancyafteruterinearteryembolization
AT tomimatsut obstetricoutcomesofpregnancyafteruterinearteryembolization
AT matsuzakis obstetricoutcomesofpregnancyafteruterinearteryembolization
AT miyaket obstetricoutcomesofpregnancyafteruterinearteryembolization
AT takiuchit obstetricoutcomesofpregnancyafteruterinearteryembolization
AT kakiganoa obstetricoutcomesofpregnancyafteruterinearteryembolization
AT mimurak obstetricoutcomesofpregnancyafteruterinearteryembolization
AT kobayashie obstetricoutcomesofpregnancyafteruterinearteryembolization
AT ueday obstetricoutcomesofpregnancyafteruterinearteryembolization
AT kimurat obstetricoutcomesofpregnancyafteruterinearteryembolization