Pregnancy Outcomes After Transvaginal Radiofrequency Ablation of Leiomyomas

OBJECTIVE: To evaluate pregnancy outcomes after transvaginal radiofrequency ablation of leiomyomas. METHODS: We conducted a retrospective review of the medical records of 226 pregnant patients after transvaginal radiofrequency ablation of leiomyomas from January 1, 2017, to February 28, 2022. RESULTS: Patients' mean age was 37.4 years. The preoperative median leiomyoma volume before transvaginal radiofrequency ablation was 52.4 mL, and the median volume reduction at 6 and 12 months was 49.4% and 69.8%, respectively. The median interval time from transvaginal radiofrequency ablation to pregnancy was 9.3 months (interquartile range 5.6-15.1 months). Pregnancy was spontaneous in 78 patients (34.5%) and by assisted reproductive technologies in 148 (65.5%). Miscarriage occurred in 36 patients (15.9%), premature delivery (before 37 weeks of gestation) in 4.1%, and preeclampsia in 4.3%. There was one instance of placenta accreta in a patient with a history of open myomectomy. There were no instances of uterine rupture, placental abruption, or fetal growth restriction. The cesarean delivery rate was 26.4%; the remaining patients had normal spontaneous vaginal deliveries. Patients with a volume of leiomyoma more than 58.6 mL had a longer interval time from transvaginal radiofrequency ablation to pregnancy (P<.05). An increased miscarriage rate was observed when the interval time to pregnancy was shorter than 5.7 months (P<.05). CONCLUSION: Pregnancy outcomes after transvaginal radiofrequency ablation of leiomyomas were similar to those of a general population with no instances of uterine rupture, placental abruption, or fetal growth restriction.