OP11.01: Outcome of ectopic uterine pregnancy (EUP) treated with methotrexate (MTX) associated with uterine artery embolisation (UAE)

Abstract

Objectives:In normal fetuses the CPR falls after 34 weeks' gestation. However, the cerebroplacental ratio (CPR) is lower in fetuses suffering from fetal growth restriction, and therefore at risk of stillbirth. It is possible that the magnitude or rate of fall could be useful in identifying those fetuses at risk. The aim of this study was to investigate the longitudinal change in small for gestational age (SGA) fetuses that had stillbirth or perinatal death. Methods: A longitudinal study of singleton pregnancies undergoing ultrasound monitoring of fetal biometry and Dopplers. Major structural abnormalities, aneuploidy, genetic syndromes or missing outcomes were excluded. Analysis of repeated measures with multilevel mixed-effects linear model (fixed effects and random effects) was performed. Regression analysis was used to investigate and adjust for potential confounding variables. ROC curve analysis was used to investigate the predictive accuracy. Results: 6906 observations were recorded in 2481 pregnancies: 1546 AGA fetuses, 31 SGA fetuses that had perinatal death, and 903 SGA fetuses that survived. There was a quadratic increase of CPR with GA in the AGA fetuses (p<0.01). CPR values were significantly lower in the SGA compared to the AGA fetuses (p<0.01). Women whose pregnancies were complicated by perinatal death were more likely to be smokers, non-Caucasian, nulliparous and delivered at an earlier GA (p<0.001 for all), compared to those who survived. CPR was significantly associated with the risk of stillbirth and perinatal death (p<0.001 for both). CPR recorded at the initial assessment had AUC 0.77 (95%CI 0.74-0.79; sensitivity 80.7%, specificity 76.6%, PPV 10.5%, NPV 99.1%), while CPR at the last assessment had AUC 0.82 (95%CI 0.79-0.84; sensitivity 80.7%, specificity 81.8%, PPV 13.2%, NPV 99.2%). Conclusions: CPR is a predictor of stillbirth and perinatal death in SGA fetuses, both at the initial and last assessments. Objectives: The purpose of the paper is to present the outcomes and safety of the association between MTX and UAE in patients with EUP. Methods: Retrospective analysis on the results of a protocol that included administration of systemic / local MTX -depending on the gestational age, in association with UAE to manage EUP. Results: Until present, a series of 3 interstitial and 6 cicatriceal EUP complied to the protocol. All the procedures were technically successful. The results of the technique were beneficial in all cases, except one case of cervical pregnancy later diagnosed as choriocarcinoma. OP11: COMPLICATIONS IN EARLY PREGNANCY: USING IMAGING AND BIOMARKERS TO PROVIDE NEW INSIGHTS Conclusions:The availability of the procedure in settings with experienced staff in gynecology and radiology is beneficial. To the best of our knowledge, this report presents some of the rare cases of interstitial pregnancy managed by angiographic uterine artery embolisation in addition to MTX. OP11.02Endometrial thickness and its value in triaging women with a pregnancy of unknown location Objectives: Seru...