Reproductive Outcomes After Laparoscopic Radiofrequency Ablation of Symptomatic Myomas [12Q]

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Abstract

INTRODUCTION:

More than 2,000 cases of laparoscopic intrabdominal ultrasound-guided radiofrequency ablation (Lap-RFA) of symptomatic myomas have been performed in the United States and internationally. Safe conception and childbearing following Lap-RFA are of great interest to patients, obstetrician-gynecologists, and reproductive endocrinologists and surgeons. Our purpose is to study the safety and gestational outcomes among reported pregnancies post Lap-RFA.

METHODS:

Gynecologic surgeons, who perform Lap-RFA, complete standardized data collection forms that capture specific details describing their consenting patients’ preoperative, intraoperative, and postoperative data as well as any pregnancy data. Reproductive outcomes have been collected and analyzed using descriptive statistics.

RESULTS:

Twenty-seven women (age range, 30-43 years old) conceived 28 times after Lap-RFA treatment. Of the 28 gestations, 23 (82.1%) resulted in full-term deliveries of healthy infants, 2 (7.1%) pregnancies are ongoing (due October and November), 2 (7.1%) pregnancies terminated in first-trimester spontaneous abortions, and 1 (3.6%) pregnancy terminated spontaneously in the second trimester. Time from treatment to conception ranged from 1 month to 28 months. Eleven (47.8%) of the births were by vaginal delivery. No cases of abnormal placentation or endometrial defect were observed.

CONCLUSION:

Accumulating evidence indicates that safe childbearing with full-term gestation can be achieved after Lap-RFA of symptomatic myomas. Continued collection of obstetric data from commercial Lap-RFA cases and Lap-RFA clinical trials are needed to support these preliminary findings.

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