Magnetic Resonance Imaging and 3-dimensional Computed Tomographic Angiography for Conservative Management of Proximal Interstitial Pregnancy by Hysteroscopic Resection After Transcatheter Arterial Chemoembolization

Chronic tubal pregnancy manifesting as a heterogeneous adnexal mass with prominent neovascularization in a woman with a negative serum β‐human chorionic gonadotropin level

“…In abnormal placentation such as placenta accreta, cesarean scar pregnancy and interstitial ectopic pregnancy, previous our reports have shown that marked neovascularization occurs around the gestational products. However, identification of heterogenous mass with prominent neovascularization observed in in the present case on multimodal imaging has never been shown in chronic tubal pregnancy.…”

“…From our limited experiences including the present case report, color Doppler ultrasonography and three‐dimensional CT angiography have shown the limited values to identify and evaluate neovascularized abnormal placental mass when independently utilized. Rather, they work complementary .…”

Magnetic resonance imaging for diagnosis and management of unruptured interstitial pregnancy

“…With the development of surgical instruments and the advent of surgical procedures, abdominal hysterectomy, which is the traditional method of management of interstitial pregnancy with loss of fertility, has been replaced by more conservative strategies enabling uterine preservation . However, the most appropriate technique to treat interstitial pregnancy remains undetermined and a variety of therapeutic options, including laparoscopic surgery, medical methotrexate treatment, uterine artery embolization, transcervical aspiration and resection, or forceps extraction, have been individually implemented without a clear management consensus to date.…”

“…Our previous studies have shown that devascularization by TACE is effective for preoperative management of cesarean scar pregnancy or retained gestational products forming a placental polyp . Although the value of TACE for the management of unruptured interstitial pregnancy has not yet been determined and its feasibility should be evaluated with further accumulation of cases, preoperative TACE appeared to be effective for the successful performance of subsequent surgical interventions in selected cases by the ability to devascularize the gestational products immediately.…”

Cervico-Isthmic Pregnancy: Early Diagnostic Imaging and Successful Dual Therapy for Uterine-Sparing Treatment

“…Although the value of TACE for the management of cervico-isthmic pregnancy has not yet been established, it could be a feasible option as an adjunctive preoperative measure instead of methotrexate therapy before surgical resection of low-lying implantation, because immediate and efficient devascularization has already been demonstrated for the management of cesarean scar pregnancy [11], retained gestational products forming a placental polyp [12], and proximal interstitial pregnancy [19]. Although recanalization of the embolized arteries and the development of an aberrant blood supply should be carefully monitored even after successful devascularization, as in the present case, TACE could be a feasible interventional option when hysteroscopic resection of an early cervico-isthmic gestational mass with prominent neovascularization is attempted.…”