An efficient conservative treatment modality for cervical pregnancy: angiographic uterine artery embolization followed by immediate curettage

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 1; pp. 31.e1 - 31.e7
• Main Authors: Wang, YanKui, MD, Xu, Bing, MD, PhD, Dai, ShuZhen, MD, Zhang, YongHua, MD, Duan, YuYing, MD, Sun, ChengJian, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 2011; Elsevier
• Subjects: Adult; Biological and medical sciences; bleeding; Cardiovascular system; cervical pregnancy; Chorionic Gonadotropin - blood; Combined Modality Therapy - methods; curettage; Dilatation and Curettage - methods; Female; Fertility; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Length of Stay; Medical sciences; Obstetrics and Gynecology; Pregnancy; Pregnancy, Ectopic - blood; Pregnancy, Ectopic - therapy; Radiodiagnosis. Nmr imagery. Nmr spectrometry; uterine artery embolization; Uterine Artery Embolization - methods; Uterine Cervical Diseases - blood; Uterine Cervical Diseases - therapy; Uterine Hemorrhage - prevention & control; Young Adult; bleeding; curettage; cervical pregnancy; uterine artery embolization; fertility; Curettage; Radiodiagnosis; Angiography; Gynecology; Instrumentation therapy; Embolization; Uterine cervix; Uterine artery; Obstetrics; Conservative treatment
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.08.048

Objective We sought to evaluate a conservative treatment modality, angiographic uterine artery embolization (UAE) followed by immediate curettage, in the treatment of cervical pregnancy. Study Design Sixteen patients with cervical pregnancy were first treated by UAE to control or prevent vaginal bleeding. Curettage of cervical canal was performed immediately after UAE to remove gestational tissue from the cervix. Clinical outcome assessments include vaginal bleeding, serum β-human chorionic gonadotropin level, cervical mass, menstruation, fertility, and hospitalization time. Results Fifteen patients were successfully treated by UAE followed by immediate curettage. One patient at very early gestational age underwent UAE only. Quick regression of serum human chorionic gonadotropin level and cervical mass, fertility preservation, and a short hospital stay were observed. Conclusion UAE followed by immediate curettage is an efficient conservative treatment for cervical pregnancy. This procedure may become a useful alternative to other conservative approaches.