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    
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.
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.
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.
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MeSH Terms
Abortifacient Agents, Nonsteroidal / administration & dosage
Catheterization, Peripheral
Combined Modality Therapy
Infusions, Intra-Arterial
Methotrexate / administration & dosage*
Pregnancy, Ectopic / therapy*
Treatment Outcome
Uterine Artery Embolization / methods*
Young Adult
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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