In the ancestral environment, a human female typically carried at
least half a dozen babies to term. The fact that modern women are
able to limit the number of children they bear has dramatic
consequences for the incidence of uterine fibroids, as well as the
clinical care of fibroids patients. "Fibroids, Menstruation,
Childbirth, and Evolution" explores these connections, integrating
a vast amount of medical knowledge about the uterus into one
volume.
During pregnancy, the mother's blood prepares for an enormous
hemostatic event: the delivery of the placenta. That fetal organ is
the vascular link between mother and offspring. At childbirth,
one-tenth of mother's cardiac output flows through the placenta,
feeding the growing child. When the placenta is sheared away from
its attachment to the uterus, two hundred large uteroplacental
arteries are ripped apart and bleed profusely into the uterine
cavity.
For many hours following delivery, uterine contractions slow
blood flow within the uterus, allowing the high concentration of
clotting factors built up in the mother's blood during pregnancy to
solidify throughout the uterine circulation and stop blood loss.
Then, hours later, the tide reverses, most of these uterine blood
clots dissolve, and more normal blood flow returns to the uterus.
This amazing process occurs with each pregnancy.
During this process, the uterus is ischemic and hypoxic. Unlike
brain and heart, which can only survive minutes of decreased blood
flow, the uterus can withstand dramatically diminished blood flow
for hours. In fact, it is natural for this to occur once every few
years. Uterine ischemia and hypoxia are a natural part of every
woman's genetic makeup.
In 1995 a group of French physicians discovered that it was
possible to emulate the physiology of childbirth by stopping blood
flow to the uterus with small plastic particles. Initially, they
injected these particles to diminish blood loss during subsequent
fibroid surgery. However, they soon learned that the injection of
these particles was therapeutic in and of itself for women with
symptomatic fibroids.
Unbeknownst to this French group, earlier, in 1964, an American
physician surgically occluded the uterine arteries to treat women
without fibroids who had excessive monthly menstrual blood loss.
Subsequent physicians have occluded the uterine arteries in various
ways to treat a third common disorder, adenomyosis. Finally, these
clinical successes suggest that future episodes of endometriosis
may be preventable in some women treated with uterine artery
closure.
Dr. Fred Burbank's comprehensive book provides insight into how
physicians can use uterine artery closure techniques to more
effectively treat uterine disorders. In addition, his book contains
short courses on magnetic resonance imaging, hemodynamics, uterine
artery embolization, and the hemostatic and hemolytic systems,
making it possible for readers less familiar with these complex
subjects to understand the text without referring to outside
sources.
About the Author Dr. Burbank is an epidemiologist, a
psychiatrist, a diagnostic radiologist, a cardiovascular
interventionalist, and an expert in women's health. He is also an
inventor-entrepreneur. For recreation, he flies, swims, and reads.
For more information, please visit his bio on
www.saltcreekmedical.com.
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