ORIGINAL RESEARCH
Prognosis criteria of the severe postembolization syndrome in patients with uterine myoma
Medical University Reaviz, Samara
Correspondence should be addressed: Elmira Т. Nurmukhametova
Chkalova, 100, Samara, 443001;
ur.xednay@mlerun
Acknowledgements: to MV Komarova, PhD, Associate Professor of the Samara University Department of Laser and Biotechnological Systems, for assistance in the statistical processing of the results.
Author contribution: Nurmukhametova ET, Shlyapnikov ME — the authors contributed to the study and manuscript writing equally.
Recently specialists take an interest in organ-preserving methods of uterine fibroids treatment, one of which is uterine artery embolization (UAE). One of the method’s negative aspects is the severe postembolization syndrome (PES) development, requiring timely initiation of adequate treatment in order to avoid severe complications that could lead to the organ removal. The study was aimed to search for the prognostic criteria of the severe PES development during the preoperative period. The study included 81 UAE-treated women aged 19–50 with 7–17 week uterine myoma. The patients’ anthropometric measurements were used, as well as the skin microcirculation data obtained by laser Doppler flowmetry together with the occlusion test. Based on prognostic criteria, models with AUC (area under ROC curve) > 0.8 were presented. According to the models, the anthropometric predictors of the severe PES were the following: age under 38.5 (р < 0.05); BMI lower than 25 kg/m2 (р < 0.05), and microcirculation value (M) prior to UAE below 9.55 PU (р = 0.001). Microvascular blood flow during the occlusion test indicate that the higher the oxygen consumption index (I), intravascular resistance (Rc), capillary blood flow reserve capacity in the models, the higher the risk of the severe PES development (р < 0.05). Low alpha angle value obtained by the occlusion test (р = 0.003) as well as the UVLF value (р = 0.004) in the models also indicate the increased risk of severe PES. Multidimensional prognostic modelling admits to expect the severe PES development prior to UAE, which allows the doctor to prepare the woman for specific management and treatment.
Keywords: laser Doppler flowmetry, uterine fibroids, uterine artery embolization, postembolization syndrome, prognostic criteria