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Efficacy and safety of endometrial ablation for treating abnormal uterine bleeding in pre‐ and postmenopausal women with liver cirrhosis
Author(s) -
Liu Qing,
Li Xiulan,
Liu JiJuan,
Song XiaoHong,
Jiang XiaoYing,
Li Wei,
Zhang Hua,
Pan Calvin Q.
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13124
Subject(s) - medicine , amenorrhea , cirrhosis , quality of life (healthcare) , endometrial ablation , observational study , gynecology , ablation , pregnancy , genetics , nursing , biology
Aim Abnormal uterine bleeding (AUB) occurs in 10–30% of women of reproductive age and up to 61% of cirrhotic women. We evaluated the efficacy and safety of endometrial ablation (NovaSure therapy) for AUB in cirrhotic women. Methods This prospective, two‐arm, observational study enrolled patients for NovaSure treatment, and they were followed for 12 months. Primary measurements were the amenorrhea rate and changes of pictorial blood loss assessment chart (PBLAC) scores at 1‐month post‐therapy. Key secondary end‐points included the longevity of amenorrhea at 12 months, safety profile, and progression of cirrhosis. Results Among 88 women, 26 were cirrhotic and 62 were non‐cirrhotic. At 1‐month post‐NovaSure treatment, a significant reduction of mean PBLAC scores was observed in cirrhotic patients compared to those at baseline (0.4 ± 1.3 vs 215.2 ± 410.9, P < 0.001), and the amenorrhea rate was 88.5%. The efficacy outcomes of the PBLAC scores and amenorrhea rate were maintained until the end of the 12‐month follow‐up. A significant improvement in quality of life scores was observed 1‐month post‐therapy compared to those at baseline (5.4 ± 3.1 vs 20.5 ± 5.5, P < 0.001). Patients' satisfaction rates were 100% and 92.31% at 6 and 12 months, respectively. The aforementioned outcomes were comparable with those in non‐cirrhotic patients. No significant progression of cirrhosis or safety concern was reported. Conclusion Cirrhotic patients on NovaSure therapy had a high rate of amenorrhea 1‐month post‐treatment, which maintained longevity for 12 months. The safety profile was similar to that in non‐cirrhotic patients.