Skip to main content
Log in

Uterine artery embolization combined with intra-arterial MTX infusion: its application in treatment of cervical pregnancy

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To investigate the efficacy and safety of uterine artery chemoembolization (UAE) combined with intra-arterial MTX infusion for the treatment of cervical pregnancy.

Methods

Retrospective chart review for 26 cervical pregnancy patients treated at Renji hospital between January 2000 and December 2012. 14 patients received UAE combined with intra-arterial MTX infusion (UAE group) and 12 patients received single intramuscular MTX injection combined with subsequent uterine curettage (non-UAE group).

Results

All 14 patients in the UAE group were treated successfully and 1 patient in the non-UAE group had 1200 ml vaginal bleeding during uterine curettage and was then treated with emergency UAE. The mean estimated blood loss during uterine curettage in the UAE group was much less than in non-UAE Group. A quicker regression of serum β-hCG level and normal menses resumed and a shorter hospital stay were observed in the UAE group than in the non-UAE group.

Conclusions

Uterine artery chemoembolization combined with intra-arterial MTX infusion is an efficient conservative treatment for cervical pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

UAE:

Uterine artery chemoembolization

MTX:

Methotrexate

IVF:

In vitro fertilization

LEEP:

Loop electrocautery excision procedures

References

  1. Hemmodi TS, Shylasree S, Bhal K, Rees A (2005) Cervical pregnancy. Internet J Gynecol Obstet 4:1

    Google Scholar 

  2. Starita A, Dimiscia A, Evangelista S, Donadio F, Starita A (2006) Cervical ectopic pregnancy: clinical review. Clin Exp Obstet Gynecol 33:47–49

    CAS  PubMed  Google Scholar 

  3. Zhang J, Liu Y, Meikle S, Zheng J, Sun W, Li Z (2008) Cesarean delivery on maternal request in southeast China. Obstet Gynecol 111:1077–1082

    Article  PubMed  Google Scholar 

  4. Ushakov FB, Elchalal U, Aceman PJ, Schenker JG (1997) Cervical pregnancy: past and future. Obstet Gynecol Surv 52:45–59

    Article  CAS  PubMed  Google Scholar 

  5. Sherer DM, Dalloul M, Santoso P, Stimphil R, Sokolovski M, Abulafia O (2004) Complete abortion of a nonviable cervical pregnancy following methotrexate treatment. Am J Perinatol 21:223–226

    Article  PubMed  Google Scholar 

  6. Cerveira I, Costa C, Santos F, Santos L, Cabral F (2005) Cervical ectopic pregnancy successfully treated with local methotrexate injection. Fertil Steril 90:e7–e10

    Google Scholar 

  7. Cepni I, Ocal P, Erkan S, Erzik B (2004) Conservative treatment of cervical ectopic pregnancy with transvaginal ultrasound-guided aspiration and single-dose methotrexate. Fertil Steril 81:1130–1132

    Article  PubMed  Google Scholar 

  8. Ash S, Farrell SA (1996) Hysteroscopic resection of a cervical ectopic pregnancy. Fertil Steril 66:842–844

    CAS  PubMed  Google Scholar 

  9. Yu B, Douglas NC, Guarnaccia MM, Sauer MV (2009) Uterine artery embolization as an adjunctive measure to decrease blood loss prior to evacuating a cervical pregnancy. Arch Gynecol Obstet 279:721–724

    Article  PubMed  Google Scholar 

  10. Jurkovic D, Hackett E, Campbell S (1996) Diagnosis and treatment of early cervical pregnancy: a review and a report of two cases treated conservatively. Ultrasound Obstet Gynecol 8:373–380

    Article  CAS  PubMed  Google Scholar 

  11. Timor-Tritsch IE, Monteagudo A, Mandeville EO, Peisner DB, Anaya GP, Pirrone EC (1994) Successful management of viable cervical pregnancy by local injection of methotrexate guided by transvaginal ultrasonography. Am J Obstet Gynecol 170:737–739

    Article  CAS  PubMed  Google Scholar 

  12. Leeman LM, Wendland CL (2000) Cervical ectopic pregnancy. Diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate. Arch Fam Med 9:72–77

    Article  CAS  PubMed  Google Scholar 

  13. Kung FT, Chang SY (1999) Efficacy of methotrexate treatment in viable and nonviable cervical pregnancies. Am J Obstet Gynecol 181:1438–1444

    Article  CAS  PubMed  Google Scholar 

  14. De La Vega GA, Avery C, Nemiroff R, Marchiano D (2007) Treatment of early cervical pregnancy with cerclage, carboprost, curettage, and balloon tamponade. Obstet Gynecol 109:505–507

    Article  Google Scholar 

  15. Steinauer JE, Diedrich JT, Wilson MW, Darney PD, Vargas JE, Drey EA (2008) Uterine artery embolization in postabortion hemorrhage. Obstet Gynecol 111:881–889

    Article  PubMed  Google Scholar 

  16. Zhuang Y, Huang L (2009) Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar. Am J Obstet Gynecol 201:152e1–152e3

    Article  Google Scholar 

  17. Sugawara J, Senoo M, Chisaka H, Yaegashi N, Okamura K (2005) Successful conservative treatment of a cesarean scar pregnancy with uterine artery embolization. Tohoku J Exp Med 206:261–265

    Article  PubMed  Google Scholar 

  18. Pattinson HA, Dunphy BC, Wood S, Saliken J (1994) Cervical pregnancy following in vitro fertilization: evacuation after uterine artery embolization with subsequent successful intrauterine pregnancy. Aust N Z J Obstet Gynaecol 34:492–493

    Article  CAS  PubMed  Google Scholar 

  19. Spies JB, Ascher SA, Roth AR, Kim J, Levy EB, Gomez-Jorge J (2001) Uterine artery embolization for leiomyomata. Obstet Gynecol 98:29–34

    CAS  PubMed  Google Scholar 

  20. Gun M, Mavrogiorgis M (2002) Cervical ectopic pregnancy: a case report and literature review. Ultrasound Obstet Gynecol 19:297–301

    Article  CAS  PubMed  Google Scholar 

  21. Xiaolin Z, Ling L, Chengxin Y et al (2010) Transcatheter intraarterial methotrexate infusion combined with selective uterine artery embolization as a treatment option for cervical pregnancy. J Vasc Interv Radiol 21:836–841

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shu Zhang.

Ethics declarations

Conflict of interest

All authors declare that we have no conflict of interest. All authors declare we have full control of all primary data and we agree to allow the journal to review the data if requested.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, S., Yan, H. & Ji, Wt. Uterine artery embolization combined with intra-arterial MTX infusion: its application in treatment of cervical pregnancy. Arch Gynecol Obstet 293, 1043–1047 (2016). https://doi.org/10.1007/s00404-015-3929-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-015-3929-1

Keywords

Navigation