A 38-year-old woman with symptomatic fibroids desires non-invasive treatment. She is counselled about magnetic resonance-guided focused ultrasound (MRgFUS). Which of the following is an absolute contraindication to this procedure?

• A Fibroid size greater than 10 cm
• B Desire for future fertility
• C Multiple fibroids (more than 4)
• D Abdominal wall scar in the ultrasound beam path ✓

Explanation

An abdominal wall scar in the ultrasound beam path is an absolute contraindication to MRgFUS because the scar tissue can absorb and reflect ultrasound energy, causing skin burns. Fibroid size greater than 10 cm and multiple fibroids are relative limitations. Desire for future fertility is not an absolute contraindication, though pregnancy data remain limited. The procedure uses focused ultrasound waves to thermally ablate fibroid tissue under MRI guidance.

Reference: Berek and Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.