Document Detail


Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: technical and clinical outcomes.
MedLine Citation:
PMID:  19457824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Masakazu Hirakawa; Tsuyoshi Tajima; Kengo Yoshimitsu; Hiroyuki Irie; Kousei Ishigami; Hideaki Yahata; Norio Wake; Hiroshi Honda
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  192     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-21     Completed Date:  2009-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1601-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Radiology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan. mahira@radiol.med.kyushu-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Cervix Uteri
Combined Modality Therapy
Feasibility Studies
Female
Humans
Immunosuppressive Agents / administration & dosage
Methotrexate / administration & dosage*
Pregnancy*
Pregnancy, Ectopic / diagnosis,  therapy*
Treatment Outcome
Uterine Artery Embolization / methods*
Uterine Hemorrhage / complications,  diagnosis,  prevention & control*
Young Adult
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 59-05-2/Methotrexate

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