Pregnancy outcome after laparoscopic cryomyolysis of uterine myomas: report of nine cases.

STUDY

OBJECTIVE

To assess pregnancy course and outcome after laparoscopic cryomyolysis.

DESIGN

Open, one-arm, observational clinical pilot study. (Canadian Task Force classification II).

SETTING

University-affiliated public hospital.

PATIENTS: Nine women who underwent laparoscopic cryomyolysis, with nine pregnancies observed.

INTERVENTION: Laparoscopic cryomyolysis was performed by penetrating along the long axis of the myoma and provoking freezing at temperature -197 degrees C.

MEASUREMENTS AND MAIN

RESULTS

After laparoscopic-directed cryomyolysis, pregnant women were evaluated by physical and ultrasonographics examinations. The median time elapsed between cryomyolysis and pregnancy was 14 months (range 7-39 months). At the beginning of pregnancy, the mean volume of myomas was 30.4 mL (range 1.8-124.6 mL). During the first 20 gestational weeks, the mean increase in volume of the nine cryo-treated myomas was 71.1% (range 21.8%-97.7%); the volume of two myomas remained stationary, and two new myomas appeared. Two patients had early miscarriage. Seven pregnancies had a regular course. Four women delivered vaginally, and three by cesarean section. There were no complications in pregnancy, postpartum, and puerperium. No cases of uterine rupture were observed.

CONCLUSIONS

The results of this series of nine pregnancies after laparoscopic cryomyolysis are promising. Laparoscopic cryomyolysis does not compromise a good pregnancy outcome and vaginal delivery. These preliminary data need to be confirmed by larger studies.