Pregnancy outcomes post high intensity focused ultrasound at Chris Hani Baragwanath Academic Hospital

Abstract

Background: High-intensity focused ultrasound (HIFU) is a promising non-invasive treatment for uterine fibroids, offering effective management while preserving fertility. Objective: This study assessed the effects of HIFU on pregnancy outcomes in women with uterine fibroids at the Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa. Methods: A retrospective descriptive study was conducted on 160 reproductive-aged women who underwent HIFU treatment between October 2015 and June 2022. Women intending to conceive post-treatment were included, whereas those with contraceptive use or hysterectomy after HIFU were excluded. The primary outcome was pregnancy status, and secondary outcomes included miscarriage, delivery, and neonatal outcomes. Statistical analyses were performed using STATA version 15.0, with chi-square tests to analyse pregnancy rates (p < 0.05). Results: The pregnancy rate after HIFU was 33.8% (54/160) with 59 pregnancies. The spontaneous pregnancy and delivery rates were 94.4% and 73.3%, respectively. There were 13 miscarriages (21.7%) and three ongoing pregnancies (5.0%). Among the 44 live births, 8 (18.2%) were preterm, and 2.3% were early and late neonatal deaths. The average age of women who conceived was 32.3 years, significantly younger than those who did not (36.2 years). Pregnancy rates were higher in women without chronic illnesses (38.1%) than in those with a history of chronic diseases (21.4%). Conclusion: While HIFU may be an alternative treatment for women with fibroids wishing to preserve their fertility, this study underscores the need for further research with larger samples to strengthen the evidence on HIFU's efficacy in this regard.