A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization
Abstract This study aimed to review the obstetric complications during subsequent pregnancies after uterine artery embolization (UAE) for postpartum hemorrhage (PPH) by exploring the relationship between prior UAE and obstetric complications through a meta-analysis. We conducted a systematic literat...
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Nature Portfolio
2021
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oai:doaj.org-article:e1f49bf351354de0895ef7030ee335dc2021-12-02T17:08:44ZA systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization10.1038/s41598-021-96273-z2045-2322https://doaj.org/article/e1f49bf351354de0895ef7030ee335dc2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96273-zhttps://doaj.org/toc/2045-2322Abstract This study aimed to review the obstetric complications during subsequent pregnancies after uterine artery embolization (UAE) for postpartum hemorrhage (PPH) by exploring the relationship between prior UAE and obstetric complications through a meta-analysis. We conducted a systematic literature review through March 31, 2021, using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in compliance with the PRISMA guidelines and determined the effect of prior UAE for PPH on the rate of placenta accreta spectrum (PAS), PPH, placenta previa, hysterectomy, fetal growth restriction (FGR), and preterm birth (PTB). Twenty-three retrospective studies (2003–2021) met the inclusion criteria. They included 483 pregnancies with prior UAE and 320,703 pregnancies without prior UAE. The cumulative results of all women with prior UAE indicated that the rates of obstetric complications PAS, hysterectomy, and PPH were 16.3% (34/208), 6.5% (28/432), and 24.0% (115/480), respectively. According to the patient background-matched analysis based on the presence of prior PPH, women with prior UAE were associated with higher rates of PAS (odds ratio [OR] 20.82; 95% confidence interval [CI] 3.27–132.41) and PPH (OR 5.32, 95% CI 1.40–20.16) but not with higher rates of hysterectomy (OR 8.93, 95% CI 0.43–187.06), placenta previa (OR 2.31, 95% CI 0.35–15.22), FGR (OR 7.22, 95% CI 0.28–188.69), or PTB (OR 3.00, 95% CI 0.74–12.14), compared with those who did not undergo prior UAE. Prior UAE for PPH may be a significant risk factor for PAS and PPH during subsequent pregnancies. Therefore, at the time of delivery, clinicians should be more attentive to PAS and PPH when women have undergone prior UAE. Since the number of women included in the patient background-matched study was limited, further investigations are warranted to confirm the results of this study.Shinya MatsuzakiMisooja LeeYoshikazu NagaseMariko JitsumoriSatoko MatsuzakiMichihide MaedaTsuyoshi TakiuchiAiko KakiganoKazuya MimuraYutaka UedaTakuji TomimatsuMasayuki EndoTadashi KimuraNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021) |
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DOAJ |
| collection |
DOAJ |
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| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Shinya Matsuzaki Misooja Lee Yoshikazu Nagase Mariko Jitsumori Satoko Matsuzaki Michihide Maeda Tsuyoshi Takiuchi Aiko Kakigano Kazuya Mimura Yutaka Ueda Takuji Tomimatsu Masayuki Endo Tadashi Kimura A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization |
| description |
Abstract This study aimed to review the obstetric complications during subsequent pregnancies after uterine artery embolization (UAE) for postpartum hemorrhage (PPH) by exploring the relationship between prior UAE and obstetric complications through a meta-analysis. We conducted a systematic literature review through March 31, 2021, using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in compliance with the PRISMA guidelines and determined the effect of prior UAE for PPH on the rate of placenta accreta spectrum (PAS), PPH, placenta previa, hysterectomy, fetal growth restriction (FGR), and preterm birth (PTB). Twenty-three retrospective studies (2003–2021) met the inclusion criteria. They included 483 pregnancies with prior UAE and 320,703 pregnancies without prior UAE. The cumulative results of all women with prior UAE indicated that the rates of obstetric complications PAS, hysterectomy, and PPH were 16.3% (34/208), 6.5% (28/432), and 24.0% (115/480), respectively. According to the patient background-matched analysis based on the presence of prior PPH, women with prior UAE were associated with higher rates of PAS (odds ratio [OR] 20.82; 95% confidence interval [CI] 3.27–132.41) and PPH (OR 5.32, 95% CI 1.40–20.16) but not with higher rates of hysterectomy (OR 8.93, 95% CI 0.43–187.06), placenta previa (OR 2.31, 95% CI 0.35–15.22), FGR (OR 7.22, 95% CI 0.28–188.69), or PTB (OR 3.00, 95% CI 0.74–12.14), compared with those who did not undergo prior UAE. Prior UAE for PPH may be a significant risk factor for PAS and PPH during subsequent pregnancies. Therefore, at the time of delivery, clinicians should be more attentive to PAS and PPH when women have undergone prior UAE. Since the number of women included in the patient background-matched study was limited, further investigations are warranted to confirm the results of this study. |
| format |
article |
| author |
Shinya Matsuzaki Misooja Lee Yoshikazu Nagase Mariko Jitsumori Satoko Matsuzaki Michihide Maeda Tsuyoshi Takiuchi Aiko Kakigano Kazuya Mimura Yutaka Ueda Takuji Tomimatsu Masayuki Endo Tadashi Kimura |
| author_facet |
Shinya Matsuzaki Misooja Lee Yoshikazu Nagase Mariko Jitsumori Satoko Matsuzaki Michihide Maeda Tsuyoshi Takiuchi Aiko Kakigano Kazuya Mimura Yutaka Ueda Takuji Tomimatsu Masayuki Endo Tadashi Kimura |
| author_sort |
Shinya Matsuzaki |
| title |
A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization |
| title_short |
A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization |
| title_full |
A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization |
| title_fullStr |
A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization |
| title_full_unstemmed |
A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization |
| title_sort |
systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/e1f49bf351354de0895ef7030ee335dc |
| work_keys_str_mv |
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