Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: Technical and clinical outcomes

Masakazu Hirakawa, Tsuyoshi Tajima, Kengo Yoshimitsu, Hiroyuki Irie, Kousei Ishigami, Hideaki Yahata, Norio Wake, Hiroshi Honda

研究成果: Contribution to journalArticle査読

41 被引用数 (Scopus)

抄録

OBJECTIVE. The objective of our study was to evaluate the technical and clinical outcomes of uterine artery embolization (UAE) along with the administration of methotrexate (MTX) for cervical ectopic pregnancy with vaginal bleeding as an alternative nonsurgical treatment to control bleeding and preserve fertility. MATERIALS AND METHODS. Eight patients (age range, 24-37 years; mean age, 30.1 years) with cervical ectopic pregnancy were treated with UAE using gelatin sponge particles to control vaginal bleeding. In seven patients, the administration of MTX was performed before, after, or before and after UAE. The follow-up periods after UAE ranged from 4 to 46 months (median, 8 months). We evaluated the UAE technique, clinical outcomes, complications, and fertility. RESULTS. In all patients, UAE could control active vaginal bleeding on gynecologic examination. In six patients, the cervical ectopic pregnancy was dramatically resolved. In the other two patients presenting with both fetal heartbeat before UAE and persistent high HCG levels, active vaginal rebleeding was observed. The rebleeding was successfully controlled by a second UAE procedure. No major complication related to UAE was detected. The uterus could be preserved in all patients. In seven patients, normal menses resumed within 2 months after UAE. In only one patient, amenorrhea continued 8 months after UAE. In all three patients who could be followed for 2 years or more, three had subsequent successful natural pregnancies, and two patients had live births. CONCLUSION. UAE along with the administration of MTX is effective in treating cervical ectopic pregnancy with vaginal bleeding while allowing the preservation of fertility.

本文言語英語
ページ(範囲)1601-1607
ページ数7
ジャーナルAmerican Journal of Roentgenology
192
6
DOI
出版ステータス出版済み - 6 1 2009

All Science Journal Classification (ASJC) codes

  • 放射線学、核医学およびイメージング

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