Expulsion of a Necrotic Uterine Fibroid After Uterine Artery Embolization Following Pregnancy Termination: A Case Report

Background: Uterine artery embolization (UAE) is a minimally invasive approach to treat uterine fibroids, rarely resulting in fibroid necrosis and expulsion. Case: A 33-year-old women underwent a dilation and evacuation complicated by hemorrhage secondary to a large uterine fibroid. The patient subsequently underwent an outpatient UAE following discharge resulting in necrotic fibroid expulsion and emergent re-presentation to the hospital for urinary retention, urgent vaginal myomectomy, and re-admission for intravenous antibiotics. Conclusion: While there are situations in which post-abortion UAEs are indicated, this case demonstrates a clinical scenario in which a UAE performed in close proximity to this patient’s pregnancy termination likely resulted in expedited complications. In future, improved care coordination and procedural timing between Gynecologic and Interventional Radiology teams may aid in preventing adverse outcomes and unnecessary procedures.