Algimantas Šimkaitis
Abstract
Arterial embolisation has been used as a method of treating haemorrhage in a variety of clinical situations, including postpartum haemorrhage, bleeding after caesarean section and bleeding following gynaecological surgery. These recommendations aims to provide guidelines for clinicians involved in care of patients undergoing uterine artery embolisation (UAE) for fibroids. Summary of recommendations: 1. The early and mid-term results of UAE are promising indicating that it is as least as safe as the surgical alternatives. It provides good symptom relief and is particularly effective for heavy menstrual bleeding. 2. For women with symptomatic fibroids, UAE should be considered as one of the treatment options as well as the conventional surgical treatments such as myomectomy and hysterectomy. 3. UAE as treatment for fibroids in women of child-bearing age who wish, or might wish, to become pregnant in the future should only be offered after fully informed discussion and should be considered on a case-by-case basis. The increased risks of caesarean section and the possibility of increased pregnancy complications should be fully understood. 4. The procedure is contraindicated in women who have evidence of current or recent infection, women who are unwilling to have a hysterectomy in any circumstances and where there is significant doubt about the diagnosis of benign pathology. 5. Patients should be seen by a gynaecologist and accurate pretreatment diagnosis is essential. MRI is recommended but good quality ultrasound is the minimum imaging requirement. 6. The procedure should only be undertaken by radiologists with specialised experience in embolisation who have undergone appropriate training. 7. The particular responsibilities of both gynaecologist and radiologist should be established prior to treatment and be set out in a relevant hospital protocol. The patient must be under a named responsible consultant at all times. Careful follow-up protocols should be established. 8. These recommendations are intended for both the National Health Service and the private sector.
Article in Lithuanian
doi:10.5200/sm-hs.2012.081
Keyword(s): uterine fibroid; endovascular treatment; uterine artery embolization; interventional radiology
DOI: 10.5200/326
Full Text: PDF