Radiological Interventions in Obstetrics and Gynaecology

Abstract

This book provides a state-of-the-art review of the technical and clinical aspects of the vascular interventional radiological (IR) procedures currently employed in obstetrics and gynaecology. A particular focus is on uterine artery embolisation for fibroid disease, which is contrasted with the main alternative uterus-conserving surgical approach of myomectomy, and with ablation therapy. Detailed consideration is also given to the role of embolisation in a variety of other less common conditions, including arteriovenous malformations, post-partum haemorrhage, abnormal placentation and pelvic congestion syndrome. IR procedures are examined from a critical gynaecological perspective and with regard to surgical alternatives. The authors include leading interventional radiologists and gynaecologists from the United Kingdom, Europe and North America. The History and Epidemiology of Fibroids -- The Medical Treatment of Uterine Fibroids -- Clinical Presentation of Uterine Fibroids -- Gynecological Assessment Prior to Uterine Artery Embolization -- Imaging Fibroids Pre and Post Uterine Artery Embolisation -- Uterine Artery Embolization Indications and Contraindications -- Clinical Results of Fibroid Embolisation, Trials and Registries -- Complications of Fibroid Embolisation -- When to Consider Ovarian Artery Embolization in UAE -- Early Post UAE Management -- Postembolization Problems and Management -- The Role of a Repeat UAE Procedure -- Myomectomy Techniques -- Myomectomy: Results and Complications -- Myomectomy Following UAE -- UAE is not Recommended for Women Wishing to Conceive -- Costing Issues and UAE in the Developing World -- Who Can and Should do Uterine Artery Embolisation -- Is There a Place for UAE in Adenomyosis? -- The Role of Magnetic Resonance Guided Focused Ultrasound for Uterine Fibroids -- Obstetric Management of Postpartum Haemorrhage -- The Role of Interventional Radiology in the Management of Abnormal Placentation -- Pelvic Venous Congestion -- Embolization in Pelvic Congestion Syndrome.