Document Detail


Transcatheter intraarterial methotrexate infusion combined with selective uterine artery embolization as a treatment option for cervical pregnancy.
MedLine Citation:
PMID:  20400332     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess the value of transcatheter intraarterial methotrexate infusion combined with selective uterine artery embolization (UAE) as a treatment option for cervical pregnancy. MATERIALS AND METHODS: Between January 2004 and June 2009, a prospective study was conducted in 20 consecutive patients with cervical pregnancy. The patients were treated with UAE with gelatin sponge particles (1-2 mm in size) to control active vaginal bleeding. Methotrexate was injected into the arteries before, during, and after UAE. RESULTS: Two of 20 patients (10%) had recurrent vaginal bleeding of approximately 50 mL daily after treatment; the other 18 (90%) had no significant vaginal bleeding after UAE. Fifteen cases (75%) were treated successfully by a single procedure and five (25%) required a subsequent curettage without blood transfusion. The degeneration of placenta was confirmed by light microscopy after curettage. The cervical gestational sac was eliminated at a mean of 41 days (range, 11-83 d). Increased serum beta-human chorionic gonadotrophin levels normalized by an average of 30 days (range, 7-49 d). The uterus was preserved and normal menses resumed within 2-4 months in all 20 women (100%). Of 16 women who attempted another pregnancy, eight (50%) achieved pregnancy: there were six term pregnancies with live births (38%) and two miscarriages (13%). No obvious complications related to treatment occurred, but a few mild side effects were observed in nine cases (45%). CONCLUSIONS: Based on this series of 20 patients, the conservative protocol of transcatheter intraarterial methotrexate infusion combined with UAE may be a feasible, effective, and safe option for cervical pregnancy.
Authors:
Zhang Xiaolin; Lu Ling; Yu Chengxin; Tan Yiqing; Wang Jun; Chen Yan; Tan Guangxi
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-04-18
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  21     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  836-41     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiology, First College of Clinical Medical Science of China Three Gorges University and Yichang Central People's Hospital, 183, Yiling Road, Yichang, Hubei 443003, China. zhangxiaolin5800@163.com
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage
Adult
Catheterization, Peripheral
Combined Modality Therapy
Female
Humans
Infusions, Intra-Arterial
Methotrexate / administration & dosage*
Pregnancy
Pregnancy, Ectopic / therapy*
Treatment Outcome
Uterine Artery Embolization / methods*
Young Adult
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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