Uterine artery embolization as an adjunctive measure to decrease blood loss prior to evacuating a cervical pregnancy

Objective The purpose of this retrospective study was to evaluate the safety and efficacy of uterine artery embolization (UAE) followed by curettage for conservative management of cervical pregnancy.Design Retrospective review.Setting Peking University First Hospital. Methods We retrospectively reviewed the clinical background and outcomes of patients with cervical pregnancy who underwent UAE followed by curettage for prevention of massive vaginal bleeding and removal of gestational tissue from the cervix. We also reviewed the literature on the role of UAE in the treatment of cervical pregnancy.Main outcome measures Clinical assessments included gestational age, gravidity, endocervical canal mass, serum beta-human chorionic gonadotrophin (b-HCG) level, blood loss, hospitalisation stay and expenses, time of resumption of menstruation and subsequent pregnancy outcomes.Results A total of 19 patients with cervical pregnancy treated with UAE followed by curettage were identified. Curettage was performed 24-72 hours after UAE in 16 patients, within 24 hours after UAE in three patients. None of the patients underwent a hysterectomy as a result of cervical pregnancy. Of the nine patients with available follow-up information (median follow-up time 59 months), eight resumed normal menstruation and one had a term pregnancy with a normal vaginal delivery. Quick regression of serum b-HCG level, low blood loss and short hospital stay were observed.Conclusion UAE combined with curettage is a safe, effective and fertility-sparing choice for treatment of patients with cervical pregnancy.

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“…Thus, UAE can be a useful adjunct in early treatment for CP. Its benefits have also been documented in previous reports …”

Section: Discussionsupporting

confidence: 64%

Successful conservative treatment of cervical pregnancy with uterine artery embolization followed by curettage: a report of 19 cases

Tao

Yin

et al. 2016

BJOG

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“…Curettage after uterine artery embolization has been reported as another approach to the conservative management of CEP (22). Case series data presented by Tao et al at the AAGL, Advancing Minimially Invasive Gynecology Worldwide (formerly known as the American Association of Gynecologic Laparoscopists) 38th Global Conference of Minimally Invasive Gynecology suggested UAE followed by dilatation and curettage as a possible alternative to hysterectomy in the management of CEP.…”

Section: Discussionmentioning

confidence: 97%

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

Zakaria

Abdallah

Shavell

et al. 2011

Fertility and Sterility

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“…In another previous study, investigators reported that UAE followed by immediate dilatation and curettage is a safe and efficient procedure for controlling serious or recurrent bleeding and preserving the patient's future fertility with a high success rate [26]. However, a risk of rebleeding still remains even after curettage because the gestational tissue may implant deeply in the cervical tissues in cases of cervical pregnancy, making complete removal difficult or impossible by curettage.…”

Section: B D F E G Uae and Administration Of Mtx For Cervical Ectopmentioning

confidence: 99%

Uterine Artery Embolization Along With the Administration of Methotrexate for Cervical Ectopic Pregnancy: Technical and Clinical Outcomes

Hirakawa

Tajima

Yoshimitsu

et al. 2009

American Journal of Roentgenology

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Uterine artery embolization as an adjunctive measure to decrease blood loss prior to evacuating a cervical pregnancy

Abstract: This report demonstrates that UAE followed by immediate evacuation of a cervical ectopic pregnancy effectively terminates a viable gestation with minimal blood loss while maintaining fertility capacity.

Cited by 36 publications

References 9 publications

Successful conservative treatment of cervical pregnancy with uterine artery embolization followed by curettage: a report of 19 cases

Successful conservative treatment of cervical pregnancy with uterine artery embolization followed by curettage: a report of 19 cases

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

Uterine Artery Embolization Along With the Administration of Methotrexate for Cervical Ectopic Pregnancy: Technical and Clinical Outcomes

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