ResearchGeneral gynecologyAn efficient conservative treatment modality for cervical pregnancy: angiographic uterine artery embolization followed by immediate curettage
Section snippets
Patients
A total of 20 patients with a confirmed cervical pregnancy were treated in our department from April 2003 through June 2009. All 20 patients wished to preserve fertility and/or obviate hysterectomy. From the original group, 4 patients were successfully treated with MTX-based therapy; 15 patients underwent UAE followed by immediate curettage; and 1 patient underwent UAE only.
Of the 16 patients (mean age, 33.2 years; range, 21–44 years) who underwent UAE, 4 patients were transferred from local
Results
Results of the treatment are summarized in Table 2. Fifteen patients were successfully managed by UAE followed by immediate curettage, and 1 patient underwent UAE only. In all UAE sessions, enlarged and tortuous uterine arteries and increased blood supply to uterus were identified (Figure 1). All sessions successfully achieved the disappearance of uterine arterial flow on bilateral iliac arteriography (Figure 2) and the arrest of vaginal bleeding on pelvic examination. The mean operating time
Comment
The treatment options for cervical pregnancy depend largely on the severity of vaginal bleeding, gestational age, initial serum hCG levels, absence or presence of fetal heartbeat, and the woman's desire to preserve fertility and/or to obviate hysterectomy. Treatments have tended to be more conservative and minimally invasive in recent years. Hysterectomy is performed only as a radical treatment in cases of intractable hemorrhage.
However, a risk of hemorrhage accompanies all options available.
Acknowledgments
We thank Dr FengSheng Yu and Dr XiaoPing Ma for their contributions to the data collection and clinical care in this study.
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Cite this article as: Wang Y, Xu B, Dai S, et al. An efficient conservative treatment modality for cervical pregnancy: angiographic uterine artery embolization followed by immediate curettage. Am J Obstet Gynecol 2011;204:31.e1-7.