Clinical applications of IR techniques in O&G TOG 2023 Flashcards
Summary of IR in O&G
Contraindications to UAE
Hoe common are ovarian-uterine anastomosis? What can be there impact on UAE?
46%
Increased risk procedure failure and post-op ovarian insufficiency
Can be detect pre-op on MRI
Failure rate of UAE if pre-op GnRH used?
60%
2 years after UAE % of patients reporting
- Moderate Improvement to pain
- Reduced bulk related Sx
- Uterine volume decrease by
- Volume decrease in dominant fibroid
- Moderate Improvement to pain 85%
- Reduced bulk related Sx 66%
- Uterine volume decrease by 50%
- Volume decrease in dominant fibroid 60%
Reintervetnion @ 5 years
UEA
Hysterectomy
UEA 32%, 23% had hysterectomy within 2 years
Hysterectomy 4%
Complications UAE immediate, early/late
Impacts of UAE on future pregnancies
64% miscarriage
CS
Adherent placenta
PPH
Myomecyomy have lower miscarriage rates
UAE for adenomysois, improvements
- Bleeding
- Pain
- Bulk related Sx
- Recurrence @ 3 years
- Bleeding 78%
- Pain 64%
- Bulk related Sx 55%
- Recurrence 24-55%
Failure rate of surgical ligation in PPH
50%
Complications UAE for PPH
6-7%
uterine necrosis, lower limbischaemia, pelvic infection, urinary frequency, bladdernecrosis, transient numbness of the buttocks andvesicovaginal fistula
PPH, adherent placenta
Use of IR in ectopic pregnancy
Selective embolisation of cervical ectopic
Medical Mx - infection hyperosmolar glucose e.g. heterotypic pregnancy
How common uterine AV malformation in reproductive age with abnormal bleeding
4%
Complications of ovarian vein embolisation for pelvic venous congestion syndrome
Pregnancy rates after Fallopian tube recanalulisation at 1 heat
41%
Re-occlusion 50% in 6 months
