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Conservative management of cervical ectopic pregnancy: utility of uterine artery embolization.
MedLine Citation:
PMID:  21227415     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the use of uterine artery embolization (UAE) in conjunction with methotrexate in the conservative treatment of cervical ectopic pregnancy (CEP). DESIGN: Case series. SETTING: Tertiary-care university hospital. PATIENT(S): Cases of CEP treated at Hutzel Women's Hospital between January 1997 and December 2008. INTERVENTION(S): Multidose methotrexate treatment with or without UAE and intra-amniotic potassium chloride injection (KCl). MAIN OUTCOME MEASURE(S): Beta-human chorionic gonadotropin level, vaginal bleeding, length of hospital stay, and future fecundity. RESULT(S): A retrospective analysis of 15 patients with CEP treated conservatively using methotrexate with leucovorin rescue (MTx/Leu) alone (group 1, five cases), with UAE as an adjunctive therapy (group 2, six cases), or also having received intra-amniotic KCl before UAE (group 3, four cases) is reported. There was no significant difference in age, parity, or gestational age among treatment groups. The median β-hCG level on presentation was 9,606 mIU/mL for group 1, 26,516 mIU/mL for group 2, and 130,464 mIU/mL for group 3. The difference was found to be statistically significant. No patients developed complications from UAE. Of the 10 patients who underwent UAE, 2 subsequently had confirmed viable pregnancies. CONCLUSION(S): Uterine artery embolization with methotrexate is an option for minimally invasive intervention in the treatment of CEP.
Authors:
Mark A Zakaria; Mazen E Abdallah; Valerie I Shavell; Jay M Berman; Michael P Diamond; David C Kmak
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-11
Journal Detail:
Title:  Fertility and sterility     Volume:  -     ISSN:  1556-5653     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Gynecology, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan.
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