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Archives of Gynecology and Obstetrics

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01-05-2016 | General Gynecology

Uterine artery embolization combined with intra-arterial MTX infusion: its application in treatment of cervical pregnancy

Authors: Shu Zhang, Huan Yan, Wen-ting Ji

Published in: Archives of Gynecology and Obstetrics | Issue 5/2016

Abstract

Objective

To investigate the efficacy and safety of uterine artery chemoembolization (UAE) combined with intra-arterial MTX infusion for the treatment of cervical pregnancy.

Methods

Retrospective chart review for 26 cervical pregnancy patients treated at Renji hospital between January 2000 and December 2012. 14 patients received UAE combined with intra-arterial MTX infusion (UAE group) and 12 patients received single intramuscular MTX injection combined with subsequent uterine curettage (non-UAE group).

Results

All 14 patients in the UAE group were treated successfully and 1 patient in the non-UAE group had 1200 ml vaginal bleeding during uterine curettage and was then treated with emergency UAE. The mean estimated blood loss during uterine curettage in the UAE group was much less than in non-UAE Group. A quicker regression of serum β-hCG level and normal menses resumed and a shorter hospital stay were observed in the UAE group than in the non-UAE group.

Conclusions

Uterine artery chemoembolization combined with intra-arterial MTX infusion is an efficient conservative treatment for cervical pregnancy.

Hemmodi TS, Shylasree S, Bhal K, Rees A (2005) Cervical pregnancy. Internet J Gynecol Obstet 4:1

Starita A, Dimiscia A, Evangelista S, Donadio F, Starita A (2006) Cervical ectopic pregnancy: clinical review. Clin Exp Obstet Gynecol 33:47–49PubMed

Zhang J, Liu Y, Meikle S, Zheng J, Sun W, Li Z (2008) Cesarean delivery on maternal request in southeast China. Obstet Gynecol 111:1077–1082CrossRefPubMed

Ushakov FB, Elchalal U, Aceman PJ, Schenker JG (1997) Cervical pregnancy: past and future. Obstet Gynecol Surv 52:45–59CrossRefPubMed

Sherer DM, Dalloul M, Santoso P, Stimphil R, Sokolovski M, Abulafia O (2004) Complete abortion of a nonviable cervical pregnancy following methotrexate treatment. Am J Perinatol 21:223–226CrossRefPubMed

Cerveira I, Costa C, Santos F, Santos L, Cabral F (2005) Cervical ectopic pregnancy successfully treated with local methotrexate injection. Fertil Steril 90:e7–e10

Cepni I, Ocal P, Erkan S, Erzik B (2004) Conservative treatment of cervical ectopic pregnancy with transvaginal ultrasound-guided aspiration and single-dose methotrexate. Fertil Steril 81:1130–1132CrossRefPubMed

Ash S, Farrell SA (1996) Hysteroscopic resection of a cervical ectopic pregnancy. Fertil Steril 66:842–844PubMed

Yu B, Douglas NC, Guarnaccia MM, Sauer MV (2009) Uterine artery embolization as an adjunctive measure to decrease blood loss prior to evacuating a cervical pregnancy. Arch Gynecol Obstet 279:721–724CrossRefPubMed

10.

Jurkovic D, Hackett E, Campbell S (1996) Diagnosis and treatment of early cervical pregnancy: a review and a report of two cases treated conservatively. Ultrasound Obstet Gynecol 8:373–380CrossRefPubMed

11.

Timor-Tritsch IE, Monteagudo A, Mandeville EO, Peisner DB, Anaya GP, Pirrone EC (1994) Successful management of viable cervical pregnancy by local injection of methotrexate guided by transvaginal ultrasonography. Am J Obstet Gynecol 170:737–739CrossRefPubMed

12.

Leeman LM, Wendland CL (2000) Cervical ectopic pregnancy. Diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate. Arch Fam Med 9:72–77CrossRefPubMed

13.

Kung FT, Chang SY (1999) Efficacy of methotrexate treatment in viable and nonviable cervical pregnancies. Am J Obstet Gynecol 181:1438–1444CrossRefPubMed

14.

De La Vega GA, Avery C, Nemiroff R, Marchiano D (2007) Treatment of early cervical pregnancy with cerclage, carboprost, curettage, and balloon tamponade. Obstet Gynecol 109:505–507CrossRef

15.

Steinauer JE, Diedrich JT, Wilson MW, Darney PD, Vargas JE, Drey EA (2008) Uterine artery embolization in postabortion hemorrhage. Obstet Gynecol 111:881–889CrossRefPubMed

16.

Zhuang Y, Huang L (2009) Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar. Am J Obstet Gynecol 201:152e1–152e3CrossRef

17.

Sugawara J, Senoo M, Chisaka H, Yaegashi N, Okamura K (2005) Successful conservative treatment of a cesarean scar pregnancy with uterine artery embolization. Tohoku J Exp Med 206:261–265CrossRefPubMed

18.

Pattinson HA, Dunphy BC, Wood S, Saliken J (1994) Cervical pregnancy following in vitro fertilization: evacuation after uterine artery embolization with subsequent successful intrauterine pregnancy. Aust N Z J Obstet Gynaecol 34:492–493CrossRefPubMed

19.

Spies JB, Ascher SA, Roth AR, Kim J, Levy EB, Gomez-Jorge J (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34PubMed

20.

Gun M, Mavrogiorgis M (2002) Cervical ectopic pregnancy: a case report and literature review. Ultrasound Obstet Gynecol 19:297–301CrossRefPubMed

21.

Xiaolin Z, Ling L, Chengxin Y et al (2010) Transcatheter intraarterial methotrexate infusion combined with selective uterine artery embolization as a treatment option for cervical pregnancy. J Vasc Interv Radiol 21:836–841CrossRefPubMed

Title: Uterine artery embolization combined with intra-arterial MTX infusion: its application in treatment of cervical pregnancy
Authors: Shu Zhang
Huan Yan
Wen-ting Ji
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2016
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-015-3929-1

At a glance: The STEP trials

Springer Medicine

Uterine artery embolization combined with intra-arterial MTX infusion: its application in treatment of cervical pregnancy

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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