ACOG Committee Opinion #293: Uterine Artery Embolization

Abstract

Uterine artery embolization for the treatment of symptomatic uterine leiomyomata has become increasingly popular. Based on current evidence, it appears that uterine artery embolization, when performed by experienced physicians, provides good short-term relief of bulk-related symptoms and a reduction in menstrual flow. Complication rates associated with the procedure are low, but in rare cases can include hysterectomy and death. There is insufficient evidence to ensure its safety in women desiring to retain their fertility, and pregnancy-related outcomes remain understudied. The American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice considers the procedure investigational or relatively contra-indicated in women wishing to retain fertility. The use of uterine artery embolization in postmenopausal women is rarely, if ever, indicated. The Committee strongly recommends that women who wish to undergo uterine artery embolization have a thorough evaluation with an obstetrician-gynecologist to help facilitate optimal collaboration with interventional radiologists and to ensure the appropriateness of this therapy, taking into account the reproductive wishes of the patient. It is also recommended that all patients considering uterine artery embolization be adequately informed about potential complications.