CASE HISTORY – June 2018

Uterine fibroid embolization in a woman of fertile age

Authors: Dmitry Maksin

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A 40-year-old nulligravid woman attended a gynaecologist. She complained prolonged and heavy menstrual bleeding. Clinical examination and ultrasound scan revealed a large fibroid in her uterus. The woman planned pregnancy in the future and wanted to preserve the uterus. She had attempted to conceive for the previous eight months but had failed. An MRI was requested for better assessment of the number, location and size of fibroids. It showed a uniformly increasing solitary 8.2 cm intramural fibroid that extended to the submucosal layer and distorted the uterine cavity. Surgical myomectomy was considered to be associated with a great risk of perioperative bleeding. Uterine fibroid embolization as alternative treatment was applied. The procedure was successful and two months after treatment the woman was symptomless and intrauterine pregnancy was confirmed on ultrasound. The gestation period was normal, the patient delivered a healthy baby via C-section in gestational week 40.