Clinical case of infertility treatment and pregnancy and delivery management following uterine artery embolization for uterine fibroids

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Abstract

Uterine artery embolization is a minimally invasive and effective method for treating symptomatic uterine fibroids; however, its impact on fertility, pregnancy course, and obstetric outcomes remains a topic of ongoing debate.

This article presents a clinical case involving the management of a patient with infertility due to uterine factors following uterine artery embolization, which was complicated by non-target embolization of the ovarian vessels. After specialized laser spectral diagnostics of endometrial status and restorative treatment, the patient achieved a spontaneous pregnancy. The pregnancy was complicated by the threat of miscarriage, cervical insufficiency, premature detachment of a normally located placenta, and preterm delivery at 32–33 weeks, as well as prolonged postpartum vaginal bleeding.

Additional studies are needed to investigate long-term reproductive outcomes in women following uterine artery embolization and to develop diagnostic and preventive approaches aimed at reducing the risk of complications. The results of this study may contribute to improving the management strategies for patients with similar complications and serve as a basis for developing treatment guidelines.

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About the authors

Vladimir M. Zuev

I.M. Sechenov First Moscow State Medical University; ART-ECO Reproductive Health Clinic

Author for correspondence.
Email: vlzuev@bk.ru
ORCID iD: 0000-0001-8715-2020
SPIN-code: 2857-0309

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

Olga I. Lisitsyna

ART-ECO Reproductive Health Clinic

Email: o_yazykova@inbox.ru
ORCID iD: 0000-0002-7775-3508
SPIN-code: 5211-4258
Russian Federation, Moscow

Elena А. Kalinina

ART-ECO Reproductive Health Clinic

Email: kalinina@art-ivf.ru
ORCID iD: 0000-0002-1273-8358

MD, Dr. Sci. (Medicine)

Russian Federation, Moscow

Nataliya V. Goncharenko

I.M. Sechenov First Moscow State Medical University; ART-ECO Reproductive Health Clinic

Email: goncharenko_n_v@staff.sechenov.ru
ORCID iD: 0000-0003-2925-1260
Russian Federation, Moscow; Moscow

Andrey V. Murashko

I.M. Sechenov First Moscow State Medical University

Email: murashkoa@mail.ru
ORCID iD: 0000-0003-0663-2909
SPIN-code: 2841-9638

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Tea A. Dzhibladze

I.M. Sechenov First Moscow State Medical University; ART-ECO Reproductive Health Clinic

Email: djiba@bk.ru
ORCID iD: 0000-0003-1540-5628
SPIN-code: 5688-1084

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

Irina D. Khokhlova

I.M. Sechenov First Moscow State Medical University

Email: irhohlova5@gmail.com
ORCID iD: 0000-0001-8547-6750
SPIN-code: 6858-5235

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Moscow

Dmitrii V. Baburin

I.M. Sechenov First Moscow State Medical University

Email: baburin_d_v@staff.sechenov.ru
ORCID iD: 0000-0003-2398-3348
SPIN-code: 3264-0730

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Ultrasound of the uterus during the patient’s first visit.

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3. Fig. 2. View of the uterine cavity during office hysteroscopy.

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4. Fig. 3. View of the uterine cavity after the birth of the fetus and removal of the placenta (a section of the cavity devoid of endometrium is visible).

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5. Fig. 4. Ultrasound of the uterus 11 weeks after birth.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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