Conservative management of cervical ectopic pregnancy

Utility of uterine artery embolization

Mark A. Zakaria, Mazen E. Abdallah, Valerie I. Shavell, Jay M. Berman, Michael Peter Diamond, David C. Kmak

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: To evaluate the use of uterine artery embolization (UAE) in conjunction with methotrexate in the conservative treatment of cervical ectopic pregnancy (CEP). Design: Case series. Setting: Tertiary-care university hospital. Patient(s): Cases of CEP treated at Hutzel Women's Hospital between January 1997 and December 2008. Intervention(s): Multidose methotrexate treatment with or without UAE and intra-amniotic potassium chloride injection (KCl). Main Outcome Measure(s): Beta-human chorionic gonadotropin level, vaginal bleeding, length of hospital stay, and future fecundity. Result(s): A retrospective analysis of 15 patients with CEP treated conservatively using methotrexate with leucovorin rescue (MTx/Leu) alone (group 1, five cases), with UAE as an adjunctive therapy (group 2, six cases), or also having received intra-amniotic KCl before UAE (group 3, four cases) is reported. There was no significant difference in age, parity, or gestational age among treatment groups. The median β-hCG level on presentation was 9,606 mIU/mL for group 1, 26,516 mIU/mL for group 2, and 130,464 mIU/mL for group 3. The difference was found to be statistically significant. No patients developed complications from UAE. Of the 10 patients who underwent UAE, 2 subsequently had confirmed viable pregnancies. Conclusion(s): Uterine artery embolization with methotrexate is an option for minimally invasive intervention in the treatment of CEP.

Original languageEnglish (US)
Pages (from-to)872-876
Number of pages5
JournalFertility and Sterility
Volume95
Issue number3
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

Fingerprint

Uterine Artery Embolization
Ectopic Pregnancy
Methotrexate
Length of Stay
Potassium Chloride
Leucovorin
Uterine Hemorrhage
Chorionic Gonadotropin
Tertiary Healthcare
Group Psychotherapy
Parity
Conservative Treatment
Gestational Age
Fertility
Therapeutics
Outcome Assessment (Health Care)
Pregnancy
Injections

Keywords

  • case series
  • Cervical pregnancy
  • ectopic pregnancy
  • infertility
  • intra-amniotic KCl
  • methotrexate
  • uterine artery embolization

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Conservative management of cervical ectopic pregnancy : Utility of uterine artery embolization. / Zakaria, Mark A.; Abdallah, Mazen E.; Shavell, Valerie I.; Berman, Jay M.; Diamond, Michael Peter; Kmak, David C.

In: Fertility and Sterility, Vol. 95, No. 3, 01.03.2011, p. 872-876.

Research output: Contribution to journalArticle

Zakaria, Mark A. ; Abdallah, Mazen E. ; Shavell, Valerie I. ; Berman, Jay M. ; Diamond, Michael Peter ; Kmak, David C. / Conservative management of cervical ectopic pregnancy : Utility of uterine artery embolization. In: Fertility and Sterility. 2011 ; Vol. 95, No. 3. pp. 872-876.
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