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J. Eric Jelovsek - One of the best experts on this subject based on the ideXlab platform.
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Incidence and risk factors for surgical intervention after Uterine Artery embolization
American Journal of Obstetrics and Gynecology, 2008Co-Authors: Amy J. Park, Justin C. Bohrer, Eunice Moon, James S. Newman, Gouri B Diwadkar, Linda D Bradley, J. Eric JelovsekAbstract:Objective To determine the incidence and risk factors for surgical intervention after Uterine Artery embolization for symptomatic Uterine fibroids. Study Design Electronic medical records of all patients who underwent Uterine Artery embolization for symptomatic Uterine leiomyomata were reviewed. Logistic regression was used to identify independent risk factors for any surgical intervention and for hysterectomy alone after Uterine Artery embolization. Results Uterine Artery embolization was performed in 454 patients during the study period, with a median follow-up time (range) of 14 (0-128) months. Overall, 99 patients (22%) underwent any surgical intervention after Uterine Artery embolization in the operating room. Risk factors for any surgical intervention included younger age ( P P P P Conclusion Patients undergoing Uterine Artery embolization have a 22% risk for requiring additional surgical intervention, but overall Uterine Artery embolization is an effective minimally invasive option.
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Incidence and risk factors for surgical intervention after Uterine Artery embolization.
American journal of obstetrics and gynecology, 2008Co-Authors: Amy J. Park, Justin C. Bohrer, Eunice Moon, James S. Newman, Gouri B Diwadkar, Linda D Bradley, J. Eric JelovsekAbstract:To determine the incidence and risk factors for surgical intervention after Uterine Artery embolization for symptomatic Uterine fibroids. Electronic medical records of all patients who underwent Uterine Artery embolization for symptomatic Uterine leiomyomata were reviewed. Logistic regression was used to identify independent risk factors for any surgical intervention and for hysterectomy alone after Uterine Artery embolization. Uterine Artery embolization was performed in 454 patients during the study period, with a median follow-up time (range) of 14 (0-128) months. Overall, 99 patients (22%) underwent any surgical intervention after Uterine Artery embolization in the operating room. Risk factors for any surgical intervention included younger age (P < .003), bleeding as an indication for Uterine Artery embolization (P < .01), presence of significant collateral ovarian vessel contribution to the uterus (P < .01), or use of 355-500 mum particles (P < .008). Patients undergoing Uterine Artery embolization have a 22% risk for requiring additional surgical intervention, but overall Uterine Artery embolization is an effective minimally invasive option.
Carlo Romanini - One of the best experts on this subject based on the ideXlab platform.
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Uterine Artery Doppler velocity waveforms in twin pregnancies.
Obstetrics and gynecology, 1993Co-Authors: Giuseppe Rizzo, Domenico Arduini, Carlo RomaniniAbstract:Objective: To compare Uterine Artery resistance index values in twin and singleton pregnancies, to examine eventual modifications of these values in twin pregnancies complicated by gestational hypertension and preeclampsia, and to determine whether resistance index values in twin pregnancies could predict the development of gestational hypertension and preeclampsia. Methods: In a cross-sectional study, reference limits for gestation were constructed for the Uterine Artery resistance index (higher, lower, and mean values) in 96 uncomplicated twin pregnancies and compared to the reference limits constructed from 315 normal singleton pregnancies. Uterine Artery resistance indexes obtained in 53 twin pregnancies complicated by either gestational hypertension or preeclampsia were compared with the newly established nomograms. The clinical efficacy of the Uterine Artery resistance index to predict hypertensive complications was evaluated prospectively in 64 twin pregnancies studied at 20-24 weeks' gestation. Results: In both singleton and twin pregnancies, Uterine Artery resistance indexes decreased linearly with advancing gestation. However, twin pregnancies showed significantly different slopes and constant values, resulting in lower resistance indexes at all gestational ages examined. No significant differences were found when comparing resistance indexes in all patients with gestational hypertension or preeclampsia to the reference limits. Statistically significant differences were obtained for the higher (P less-than-or-equal-to .05) and mean (P less-tha-or-equal-to .01) resistance indexes when the comparison was restricted to preeclamptic patients. In the twin pregnancies studied at 20-24 weeks' gestation, the diagnostic efficacy of the Uterine Artery resistance index for predicting the development of gestational hypertension and/or preeclampsia was disappointingly low (k < 0.10). Conclusions: Resistance index values in the Uterine Artery are lower in twin pregnancies than in singleton pregnancies. Gestational hypertension and preeclampsia may occur in twin pregnancies despite normal Uterine Artery velocity waveforms, suggesting a limited role of this measurement in the management and prediction of hypertensive complications in twin pregnancies.
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Uterine Artery Doppler velocity waveforms in twin pregnancies.
Obstetrics and gynecology, 1993Co-Authors: Giuseppe Rizzo, Domenico Arduini, Carlo RomaniniAbstract:To compare Uterine Artery resistance index values in twin and singleton pregnancies, to examine eventual modifications of these values in twin pregnancies complicated by gestational hypertension and preeclampsia, and to determine whether resistance index values in twin pregnancies could predict the development of gestational hypertension and preeclampsia. In a cross-sectional study, reference limits for gestation were constructed for the Uterine Artery resistance index (higher, lower, and mean values) in 96 uncomplicated twin pregnancies and compared to the reference limits constructed from 315 normal singleton pregnancies. Uterine Artery resistance indexes obtained in 53 twin pregnancies complicated by either gestational hypertension or preeclampsia were compared with the newly established nomograms. The clinical efficacy of the Uterine Artery resistance index to predict hypertensive complications was evaluated prospectively in 64 twin pregnancies studied at 20-24 weeks' gestation. In both singleton and twin pregnancies, Uterine Artery resistance indexes decreased linearly with advancing gestation. However, twin pregnancies showed significantly different slopes and constant values, resulting in lower resistance indexes at all gestational ages examined. No significant differences were found when comparing resistance indexes in all patients with gestational hypertension or preeclampsia to the reference limits. Statistically significant differences were obtained for the higher (P < or = .05) and mean (P < or = .01) resistance indexes when the comparison was restricted to preeclamptic patients. In the twin pregnancies studied at 20-24 weeks' gestation, the diagnostic efficacy of the Uterine Artery resistance index for predicting the development of gestational hypertension and/or preeclampsia was disappointingly low (k < 0.10). Resistance index values in the Uterine Artery are lower in twin pregnancies than in singleton pregnancies. Gestational hypertension and preeclampsia may occur in twin pregnancies despite normal Uterine Artery velocity waveforms, suggesting a limited role of this measurement in the management and prediction of hypertensive complications in twin pregnancies.
Premal H Thaker - One of the best experts on this subject based on the ideXlab platform.
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Uteroenteric fistula after Uterine Artery embolization.
Obstetrics and gynecology, 2011Co-Authors: Summer B Dewdney, Naganathan B Mani, Darryl A Zuckerman, Premal H ThakerAbstract:Uterine Artery embolization is a common procedure for symptomatic leiomyomas and is being used as a less invasive alternative to a hysterectomy. This is a report of an uteroenteric fistula after Uterine Artery embolization. A 50-year-old woman developed an uteroenteric fistula that was seen on a computed tomography scan 6 months after she had an uncomplicated Uterine Artery embolization for symptomatic leiomyomas. She was managed surgically with a hysterectomy and small bowel resection with reanastomosis. Uteroenteric fistula can occur as a complication of Uterine Artery embolization for leiomyoma management.
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Uteroenteric fistula after Uterine Artery embolization.
Obstetrics & Gynecology, 2011Co-Authors: Summer B Dewdney, Darryl A Zuckerman, Naganathan Mani, Premal H ThakerAbstract:Background Uterine Artery embolization is a common procedure for symptomatic leiomyomas and is being used as a less invasive alternative to a hysterectomy. This is a report of an uteroenteric fistula after Uterine Artery embolization. Case A 50-year-old woman developed an uteroenteric fistula that was seen on a computed tomography scan 6 months after she had an uncomplicated Uterine Artery embolization for symptomatic leiomyomas. She was managed surgically with a hysterectomy and small bowel resection with reanastomosis. Conclusion Uteroenteric fistula can occur as a complication of Uterine Artery embolization for leiomyoma management.
Renato Seracchioli - One of the best experts on this subject based on the ideXlab platform.
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pregnancy outcomes after treatment for fibromyomata Uterine Artery embolization versus laparoscopic myomectomy
American Journal of Obstetrics and Gynecology, 2004Co-Authors: Jay M. Goldberg, Leonardo Pereira, Vincenzo Berghella, James Diamond, Emile Daraï, Piero Seinera, Renato SeracchioliAbstract:Abstract Objective The objective of this study was to compare pregnancy outcomes in women with fibromyomata who were treated with Uterine Artery embolization to the outcomes in women who were treated with laparoscopic myomectomy. Study design We compiled data from 53 pregnancies after Uterine Artery embolization and 139 pregnancies after laparoscopic myomectomy. We calculated and compared rates for spontaneous abortion, postpartum hemorrhage, preterm delivery, cesarean delivery, small for gestational age, and malpresentation. Results Pregnancies after Uterine Artery embolization had higher rates of preterm delivery (odds ratio, 6.2; 95% CI, 1.4, 27.7) and malpresentation (odds ratio, 4.3; 95% CI, 1.0, 20.5) than did pregnancies after laparoscopic myomectomy. The risks of postpartum hemorrhage (odds ratio, 6.3; 95% CI, 0.6, 71.8) and spontaneous abortion (odds ratio, 1.7; 95% CI, 0.8, 3.9) after Uterine Artery embolization were similarly higher than the risks after laparoscopic myomectomy; however, these differences were not statistically significant. Conclusion Pregnancies in women with fibromyomata who were treated by Uterine Artery embolization, compared with pregnancies after laparoscopic myomectomy, were at increased risk for preterm delivery and malpresentation.
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Pregnancy outcomes after treatment for fibromyomata: Uterine Artery embolization versus laparoscopic myomectomy ☆
American journal of obstetrics and gynecology, 2004Co-Authors: Jay M. Goldberg, Leonardo Pereira, Vincenzo Berghella, James Diamond, Emile Daraï, Piero Seinera, Renato SeracchioliAbstract:The objective of this study was to compare pregnancy outcomes in women with fibromyomata who were treated with Uterine Artery embolization to the outcomes in women who were treated with laparoscopic myomectomy. We compiled data from 53 pregnancies after Uterine Artery embolization and 139 pregnancies after laparoscopic myomectomy. We calculated and compared rates for spontaneous abortion, postpartum hemorrhage, preterm delivery, cesarean delivery, small for gestational age, and malpresentation. Pregnancies after Uterine Artery embolization had higher rates of preterm delivery (odds ratio, 6.2; 95% CI, 1.4, 27.7) and malpresentation (odds ratio, 4.3; 95% CI, 1.0, 20.5) than did pregnancies after laparoscopic myomectomy. The risks of postpartum hemorrhage (odds ratio, 6.3; 95% CI, 0.6, 71.8) and spontaneous abortion (odds ratio, 1.7; 95% CI, 0.8, 3.9) after Uterine Artery embolization were similarly higher than the risks after laparoscopic myomectomy; however, these differences were not statistically significant. Pregnancies in women with fibromyomata who were treated by Uterine Artery embolization, compared with pregnancies after laparoscopic myomectomy, were at increased risk for preterm delivery and malpresentation.
Michael Sarosi - One of the best experts on this subject based on the ideXlab platform.
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Uterine Artery pseudoaneurysm after Uterine cervical conization.
Obstetrics and gynecology, 2014Co-Authors: Joses Jain, Sharon O'leary, Michael SarosiAbstract:Uterine Artery pseudoaneurysm is a rare postoperative complication. Several case reports describe this occurring after cesarean deliveries, typically presenting as delayed postoperative bleeding. A 26-year-old woman (gravida 1, para 0010) underwent a cervical cold-knife conization. She later presented three times over the subsequent 18 days with intermittent vaginal hemorrhage. After unsuccessful treatment with suture, prothrombotic agents, and ferric subsulfate, arteriography was performed with no abnormality identified. A bilateral iliac and Uterine arteriography was repeated to facilitate prophylactic Uterine Artery embolization. A pseudoaneurysm of the right Uterine Artery was then visualized and embolized, resolving the symptoms. Injury to the Uterine Artery causing pseudoaneurysm formation can cause persistent vaginal hemorrhage after cervical conization and may elude diagnosis by arteriography.
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Uterine Artery pseudoaneurysm after Uterine cervical conization
Obstetrics & Gynecology, 2014Co-Authors: Joses Jain, Sharon O’leary, Michael SarosiAbstract:Background Uterine Artery pseudoaneurysm is a rare postoperative complication. Several case reports describe this occurring after cesarean deliveries, typically presenting as delayed postoperative bleeding. Case A 26-year-old woman (gravida 1, para 0010) underwent a cervical cold-knife conization. She later presented three times over the subsequent 18 days with intermittent vaginal hemorrhage. After unsuccessful treatment with suture, prothrombotic agents, and ferric subsulfate, arteriography was performed with no abnormality identified. A bilateral iliac and Uterine arteriography was repeated to facilitate prophylactic Uterine Artery embolization. A pseudoaneurysm of the right Uterine Artery was then visualized and embolized, resolving the symptoms. Conclusion Injury to the Uterine Artery causing pseudoaneurysm formation can cause persistent vaginal hemorrhage after cervical conization and may elude diagnosis by arteriography.
