Conservative management of cervical ectopic pregnancy: utility of uterine artery embolization

Zakaria, M.A.; Abdallah, M.; Shavell, Valerie I.; Berman, Jay M.; Diamond, Michael P.; Kmak, David

doi:10.1016/j.fertnstert.2010.12.024

Cited by 55 publications

(24 citation statements)

References 21 publications

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“…This elevated hCG level is consistent with a previous report [24]. Another report indicated that UAE should be applied after systematic MTX therapy andif a fetal heart beat is present-lethal intraamniotic KCL injection should be considered in cases with very high hCG level (>34,000 mIU/mL) [25]. Conversely, the hCG level at admission could not predict the requirement for UAE in our study because we observed that the patients with low hCG level after MTX therapy as well as with low initial level needed emergency UAE for a moderate hemorrhage.…”

Section: Discussionsupporting

confidence: 91%

“…Previous reports have suggested that UAE alone may be insufficient to treat a cervical pregnancy effectively and that concurrent medical therapy might be indicated [23,25]. In our study, only one patient had a spontaneous abortion after UAE caused by a heavy hemorrhage.…”

Section: Discussionmentioning

confidence: 45%

“…Viable pregnancies have been reported after UAE [25,27]. In our study, two patients subsequently had viable pregnancies although assisted reproduction techniques-one of the risk factors for cervical pregnancy-were used in eight cases including six cases of IVF-ET.…”

Section: Discussionmentioning

confidence: 70%

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Conservative management of cervical pregnancy: The utility of methotrexate treatment and uterine artery embolization

Masuyama¹,

Inoue²,

Nobumoto³

et al. 2013

OJOG

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The aim of this retrospective case series report is to evaluate systemic methotrexate therapy in conjunction with uterine artery embolization (UAE) in the conservative management of cervical pregnancy. We examined clinical presentations, treatments, and therapeutic outcomes in fifteen patients with a cervical pregnancy who wished for preservation of fertility, treated at Okayama University Hospital between 1998 and 2012. Twelve patients received systemic methotrexate including five treated with UAE. One was treated with UAE alone. Two patients received neither UAE nor methotrexate because of a low human chorionic gonadotropin (hCG) level and poor blood flow around the gestational sac (GS). An increased GS size and the elevated hCG level during methotrexate therapy might be risk factors for emergent UAE. Two of six patients treated with UAE had subsequent confirmed viable pregnancies. In patients with a cervical pregnancy, methotrexate therapy in combination with UAE can be considered as an option before performing a hysterectomy with suitable counseling about the risk of loss of fertility. Careful observation of the GS size and hCG level during methotrexate therapy might be important for management.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 45%

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Conservative management of cervical pregnancy: The utility of methotrexate treatment and uterine artery embolization

Masuyama¹,

Inoue²,

Nobumoto³

et al. 2013

OJOG

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“…Preoperative uterine artery embolization may be useful to help control haemorrhage. 7 In haemodynamically unstable patients or those who have failed medical management, dilatation and curettage is required. The risk of haemorrhage can be reduced by trans vaginal ligation of cervical branches of uterine arteries, cervical circlage, or intracervical injection of vasopressin in addition to uterine artery embolization.…”

Section: Discussionmentioning

confidence: 99%

Medical Management of Cervical Ectopic Pregnancy

Arif¹,

Mukhtar²,

Naheed³

et al. 2016

Annals KEMU

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Cervical ectopic pregnancy is a rare condition with implantation in the endocervical canal below the closed internal os. It accounts for less than 1% of all ectopic pregnancies. It is associated with high morbidity and mortality. A case of cervical ectopic pregnancy is reported. She was a young nulliparous female, timely referred from peripheral hospital. She was treated successfully with medical management and thus fertility was preserved.

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“…UAE reduces fibroma size and its complications [10,11]. UAE has been used to control severe bleeding after childbirth (abnormal placental adhesion) or treat cervical and interstitial pregnancies as well as cesarean scar pregnancy and has had successful results [12][13][14][15][16]. Patients treated with UAE have shorter hospital stay and faster recovery time than patients who have hysterectomy, but there is the probability of re-hospitalization and additional treatment to control bleeding [17,18].…”

Section: Introductionmentioning

confidence: 99%

The Comparison of Ovarian Reserve After Uterine Artery Embolization and Hysterectomy for Uterine Fibroma

Veisi¹

2014

J Clin Gynecol Obstet

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Conservative management of cervical ectopic pregnancy: utility of uterine artery embolization

Cited by 55 publications

References 21 publications

Conservative management of cervical pregnancy: The utility of methotrexate treatment and uterine artery embolization

Conservative management of cervical pregnancy: The utility of methotrexate treatment and uterine artery embolization

Medical Management of Cervical Ectopic Pregnancy

The Comparison of Ovarian Reserve After Uterine Artery Embolization and Hysterectomy for Uterine Fibroma

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