Abstract

Objective: A mini-systematic review of pregnancy outcomes after Radiofrequency Ablation (RFA) of uterine fibroids with Sonata® System.
Data sources: A literature search was conducted using PubMed, ScienceDirect, Cochrane Library and Medline, from database inception to 20th July 2023.
Method: Three reviewers (VT, CA, PT) conducted independent literature searches. Studies that met the criteria based on title, abstract or keyword underwent full-text review. Publications were included if they reported pregnancies and/or obstetric outcomes after transcervical RFA of myomas.
Result: A total of 441 publications were initially identified and screened, 41 underwent full-text review, and 6 publications were ultimately included. Among the RFA patients who conceived, the average age at ablation was 37 years old (range, 22-45 years). Most patients had between 1 and 6 myomas ablated and myomas size ranged from 1cm to cm, FIGO type 2-5. There were 8 spontaneous abortions and 36 pregnancies, of which 60% were caesarean deliveries. There were no cases of uterine rupture, invasive placentation, stillbirth, fetal growth restriction nor neonatal complications. Obstetric complications were comparable with the general population.
Conclusion: Treatment of uterine fibroids with the Sonata® system did not show any adverse pregnancy outcome, including women with recurrent abortion and women undergoing in vitro fertilization.

Keywords:Sonata® system; Transcervical radiofrequency ablation; Uterine fibroid; Systematic review; Pregnancye

Abbreviations:FDA: Food and Drug Administration; TFA: Transcervical Fibroid Ablation; RF: Radio Frequency; NOS: Newcastle Ottawa Scale; ART: Assisted Reproductive Technology