| Objective:To evaluate the effects of uterine artery embolization for uterine fibroids,scar pregnancy and postpartum hemorrhage on long-term pregnancy outcomes.Methods:Relevant literatures of the impact of uterine artery embolization(UAE)for uterine fibroids,cesarean scar pregnancy and postpartum hemorrhage on pregnancy outcomes published in the databases of PUBMED,EMBASE,Web of Science,CNKI,Wanfang,and VIP database to December 2019 were searched.The included literatures were screened,relevant data were extracted,and the Review Manager 5.3 software was used to perform a meta-analysis of the pregnancy rate,spontaneous abortion rate,live birth rate,and postoperative ovarian function in the two groups of patients.Results:1.A total of 36 eligible documents were included.A total of 24 eligible documents were included in the uterine fibroid group,with a total sample size of8,620,of which 6,240 were in the experimental group and 2380 in the control group;6 eligible documents were included in the cesarean scar pregnancy group,with a total sample size of 569.Among them,there were 302 cases in the experimental group and 267 cases in the control group;6 articles meeting the requirements were included in the postpartum hemorrhage group,with a total sample size of 729 cases,of which 296 cases were in the experimental group and 433 cases were in the control group.2.Statistical analysis results:(1)After UAE treatment of uterine fibroids,the serum FSH level increased and the AMH level decreased.There was no significant difference.However,the antral follicle count(AFC)was lower than before,and the difference was statistically significant.UAE compared with uterine fibroids removal has a lower pregnancy rate after surgery,the difference is statistically significant;natural abortion rate is higher,the difference is not statistically significant;term live birth rate is lower,the difference is not statistically significant.(2)Serum AMH and FSH levels increased after uterine artery embolization for scar pregnancy,and the difference was statistically significant.Ovarian AFC decreased,and the difference was not statistically significant.Compared with lesion resection or curettage,UAE reduced the pregnancy rate,increased the spontaneous abortion rate,and reduced the term live birth rate.The differences were not statistically significant.(3)The serum FSH level of patients with postpartum hemorrhage after UAE treatment was lower than that of non-UAE,and the difference was not statistically significant.The pregnancy rate and term live birth rate of patients after UAE were lower than those who did not receive UAE,and the spontaneous abortion rate was higher.The differences were not statisticallysignificant.Conclusion:Uterine artery embolization for uterine fibroids can reduce postoperative pregnancy rate and ovarian antral follicle count.Uterine artery embolization for scar pregnancy has no adverse effects on future pregnancy outcomes and ovarian function;Uterine artery embolization for postpartum hemorrhage has no adverse effects on future pregnancy outcomes and ovarian function.For women with uterine fibroids who have fertility requirements in the future,uterine artery embolization may affect their future fertility and should be selected carefully.Uterine artery embolization for scar pregnancy and postpartum hemorrhage is safe for women with fertility requirements. |
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