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.
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.
Authors: Raghav Goel; Kyle Anderson; Joel Slaton; Franz Schmidlin; Greg Vercellotti; John Belcher; John C Bischof Journal: J Biomech Eng Date: 2009-07 Impact factor: 2.097