en Obstetrics & Gynicology Obstetrics & Gynicology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0000ff;"><strong><em>Background</em></strong><em>:</em></span> The purpose of the study was to evaluate the effectiveness and safety of thermal balloon ablation in women with high anesthetic and surgical risk compared to invulnerable women according to the American Society of Anesthesia (ASA) physical status stratification.<br> <span style="color:#0000ff;"><strong><em>Methods</em></strong><em>:</em></span> This report was based on a retrospective cohort study of women with heavy menstrual bleeding (HMB) who were eligible for treatment with Cavaterm^TM plus during 2012-2017. Women were classified as high-risk (HR) or low-risk (LR) cohorts based on ASA physical status stratification. The primary outcome includes amenorrhea in the twelfth months after the treatment. Risk adjustments were performed using regression models.<br> <span style="color:#0000ff;"><strong><em>Results</em></strong><em>:</em> </span>This research study consisted of 63 women with mean age 44.42&plusmn;5.48. Mean of body mass index (BMI) in the HR cohort was higher than the LR cohort (31.48&plusmn;6.22 vs 26.83&plusmn; 3.51, P=0.005) and results were also similar considering the uterine length (mm) between HR and LR women (58.27&plusmn;35.70 vs 30.92&plusmn; 35.30, P=0.01). The primary outcome of treatment after a one-year follow-up in the two groups (HR and LR) was 31 (93.9%) and 15 (78.9%), respectively. After adjusting for known confounders including age, uterine length, parity, dysmenorrheal, the adjusted odds ratio was 0.94 (95% CI, 0.14&ndash; 2.5; P= 0.60).<br> <span style="color:#0000ff;"><strong><em>Conclusion</em></strong><em>:</em> </span>For women with high anesthetic and surgical risks derived from serious underlying co morbidities, endometrial ablation can provide a minimally invasive, safe, and effective therapy for heavy menstrual bleeding.</span></span> Endometrial ablation, Menorrhagia, Amenorrhea, Recovery, Anesthesia, Obese women 336 341 http://caspjim.com/browse.php?a_code=A-10-863-2&slc_lang=en&sid=1 Zinatossadat Bouzari z_b412003@yahoo.com 100319475328460029403 100319475328460029403 No Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Ebrahim Alijanpour dralijanpour@yahoo.com 100319475328460029404 100319475328460029404 No The Clinical Research Development Unite of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran shahla yazdani shahla_yazdani_1348@yahoo.com 100319475328460029405 100319475328460029405 No Fertility and Infertility Research Health Center, Health Research Institute, Babol of University of Medical Science, Babol, Iran Azita Ghanbarpour dr_ghanbarpour@yahoo.com 100319475328460029406 100319475328460029406 Yes Fertility and Infertility Research Health Center, Health Research Institute, Babol of University of Medical Science, Babol, Iran Ali Bijani ali_bizhani@yahoo.com 100319475328460029407 100319475328460029407 No Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Tahereh Ashraf Ganjoei rohanresearch88@gmail.com 100319475328460029408 100319475328460029408 No Department of Obstetrics and Gynecology, Preventative Gynecology Research Center (PGRC), Imam Hussein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran hemmat gholinia h_gholinia@yahoo.com 100319475328460029409 100319475328460029409 No Health Research Institute, Babol University of Medical Sciences, Babol, Iran