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Re: UAE Option From: art fougner, md (evsono@pipeline.com) Wed Aug 25 20:26:08 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "GEN: Suing The Ob-Gyns" Previous message: art fougner, md: "GYN: Circumcision of Daughters is Optional from the Religious Point of View" In reply to: Garry E. Siegel, M.D.: "Re: UAE Option" You may wish to tread lightly should your patients wish to preserve fertility with UAE. Pregnancy outcomes after treatment for fibromyomata: uterine artery embolization versus laparoscopic myomectomy Jay Goldberg, MD a * [MEDLINE LOOKUP] Leonardo Pereira, MD a [MEDLINE LOOKUP] Vincenzo Berghella, MD a [MEDLINE LOOKUP] James Diamond, PhD a [MEDLINE LOOKUP] Emile Dara, MD b [MEDLINE LOOKUP] Piero Seinera, MD c [MEDLINE LOOKUP] Renato Seracchioli, MD d [MEDLINE LOOKUP] 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. Am J Obstet Gynecol 2004 Jul;191(1):18-21. art At Wed, 25 Aug 2004, Garry E. Siegel, M.D. wrote: > >If a patient has fibroids amenable to UAE, and no other condition >(pelvic pain, suspected endometriosis), then I bring it up. > >Garry > >At Wed, 25 Aug 2004, Gerald P. Rodríguez wrote: >> >>Yesterday's Wall Street Journal, top front-page story, carried a story quite critical of gynecologists who do "hundreds of thousands" of hysterectomies and allegedly seem to almost always fail to offer Uterine Artery Embolization to their patients as an alternative to hysterectomy. >> >>Question: How many of you "offer" or inform patients of this option as a matter or routine? >> >>Gerald P. Rodriguez, M.D., FACOG >>Santa Fe >>~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >>"With malice toward none; with charity for all; with firmness in the right >>as God gives us to see the right, let us strive on to finish the work we are in; >>to bind up the nation's wounds; to care for him who shall have borne >>the battle and for his widow, and his orphan--to do all which may achieve >>and cherish a just and a lasting peace among ourselves, and with all nations." >> >>Abraham Lincoln: Second Inaugural Address, March 4, 1865 >>~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- art fougner, md ich bin ein New Yorker Next message: art fougner, md: "GEN: Suing The Ob-Gyns" Previous message: art fougner, md: "GYN: Circumcision of Daughters is Optional from the Religious Point of View" In reply to: Garry E. Siegel, M.D.: "Re: UAE Option"

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