Uterine Artery Embolization Followed by Dilation and Curettage for Cervical Pregnancy

  title={Uterine Artery Embolization Followed by Dilation and Curettage for Cervical Pregnancy},
  author={Yoshifumi Nakao and Masatoshi Yokoyama and Tsuyoshi Iwasaka},
  journal={Obstetrics \& Gynecology},
BACKGROUND: Cervical pregnancy can be a life-threatening condition due to the risk of severe hemorrhage. Progression of ultrasonographic diagnostic technology has allowed the early detection of cervical pregnancy. However, a standard treatment protocol for fertility preservation has not yet been established. CASE: Two women with cervical pregnancy presented with cardiac activity at 6 and 7 weeks of gestation. They were treated with transfemoral uterine artery embolization followed by dilation… Expand
Uterine artery embolization as an adjunctive measure to decrease blood loss prior to evacuating a cervical pregnancy
This report demonstrates that uterine artery embolization followed by immediate evacuation of a cervical ectopic pregnancy effectively terminates a viable gestation with minimal blood loss while maintaining fertility capacity. Expand
An efficient conservative treatment modality for cervical pregnancy: angiographic uterine artery embolization followed by immediate curettage.
UAE followed by immediate curettage is an efficient conservative treatment for cervical pregnancy and may become a useful alternative to other conservative approaches. Expand
Laparoscopic uterine artery occlusion before cervical curettage in cervical ectopic pregnancy: Safe and effective for preventing massive bleeding
It is found that laparoscopic uterine artery occlusion before cervical curettage is more effective method for preventing massive bleeding. Expand
Uterine Artery Embolization and Methotrexate Infusion as Sole Management for Caesarean Scar and Cervical Ectopic Pregnancies: A Single-Center Experience and Literature Review
UAE combined with intra-arterial MTX infusion resulted in resolution of ectopic pregnancies with control of hemorrhage and without hysterectomy in this small group of patients. Expand
Diagnosis and Management of Cervical Pregnancy
A 25-year-old woman, gravida 2, with a previous history of lower-segment cesarean delivery, underwent medical termination of pregnancy at 2 months of pregnancy by pharmaceutical methods followed by dilatation and curettage and responded well to one course of methotrexate. Expand
Cervical pregnancy: A case series and a review of current clinical practice
It is postulate that the preventive use of uterine artery embolization in combination with standard MTX treatment could contribute to reduce the risk of excessive bleeding and facilitate spontaneous expulsion. Expand
The Use of Ultrasonography in Conservative Management of Cervical Pregnancy
Although the etiology of cervical pregnancy is unclear, previous uterine procedures such as dilation and curettage and cesarean section, pelvic inflammatory disease, use of an intrauterine device (IUD), and in vitro fertilization (IVF) are likely causative or contributing factors. Expand
Angiographic findings after vaginal gauze packing: New insight into an old technique
Vaginal gauze packing is an effective, rapid, and convenient hemostatic procedure able to be carried out in a time‐sensitive and challenging situation and gives clinicians more time to improve the patients' general status and arrange for transfusion and further definitive treatment. Expand
Uterine artery embolization in the treatment of postpartum uterine hemorrhage.
The threshold for UAE in women with PPH should be low, as it is associated with a high clinical effectiveness rate and a low complication rate, and uterine artery pseudoaneurysms should be suspected in women presenting with secondary PPH after cesarean section. Expand
Outcomes of Bilateral Uterine Artery Chemoembolization in Combination with Surgical Evacuation or Systemic Methotrexate for Cervical Pregnancy.
Bilateral uterine artery chemoembolization is effective in controlling and preventing massive hemorrhage associated with CP and proved to treat CP with optimal recovery time, few outpatient follow-ups, and efficient fertility preservation when combined with surgical evacuation or systemic MTX. Expand


Safe resectoscopic evacuation of a 10-week viable cervical pregnancy after transfemoral bilateral uterine artery embolization.
Uterine artery embolotherapy followed by resectoscopic evacuation of cervical pregnancy minimized morbidity and preserved the uterus. Expand
Preoperative uterine artery embolization and evacuation in the management of cervical pregnancy: report of two cases.
This work reports two cases of cervical pregnancy that were successfully treated with preoperative uterine artery embolization and removal of gestational material without ancillary procedures, and the therapeutic modality seems to be safe and effective for conservative management of cervicalregnancy. Expand
Treatment of cervical pregnancy with methotrexate
  • T. Hung, C. Jeng, Y. Yang, K. G. Wang, C. Lan
  • Medicine
  • International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
  • 1996
If a cervical pregnancy is present and diagnosed early and methotrexate treatment, administered either systemically or locally, is effective as the definitive therapy, this experience with early ultrasonographic diagnosis and fertility‐preserving complete medical treatment of cervical pregnancy concludes. Expand
Cervical pregnancy: past and future.
The use of cervical canal tamponade with a Foley catheter balloon led to reliable hemostasis in 92.3 percent of cases in which this method was used, and the main problem of conservative treatment is life-threatening hemorrhage after pregnancy evacuation. Expand
Clinical Outcomes of Patients treated for Cervical Pregnancy with or without Methotrexate
In conclusion, early diagnosis, appropriate MTX regimen in combination of necessary adjuvant conservative procedures could contribute to successful treatment with preservation of the uterus and future reproductive ability. Expand
Conservative treatment using a methotrexate-lipiodol emulsion containing non-ionic contrast medium for a cervical ectopic pregnancy.
It is indicated that use of an MTX emulsion enables slow release of MTX and may be applicable for conservative treatment of ectopic pregnancies, including cervical pregnancy. Expand
Prognostic factors for an unsatisfactory primary methotrexate treatment of cervical pregnancy: a quantitative review.
A concomitant feticide was found to enhance the therapeutic effect of MTX treatment if embryonic cardiac activity was evident and administration of a high dose ofMTX did not seem to be more effective than a lower one. Expand
Treatment of Early Cervical Pregnancy With Cerclage, Carboprost, Curettage, and Balloon Tamponade
Early cervical pregnancy was treated with combined cervical cerclage, intracervical infiltration of carboprost, curettage, and balloon tamponade and severe hemorrhage during suction curettages and the adverse effects and complications of systemic methotrexate treatment were avoided. Expand