The mode of treatment of cervical pregnancy

Abstract

The article demonstrates that the mode of treatment of cervical pregnancy consists on one hand in application of super-selective embolization of uterine arteries by means of intra-arterial introduction of micro-spheres Embosphere® with dimensions 700-900 mkm and micro-spheres HepaSphereTM with dimensions 150-200 mkm and 25 mg of methotrexate. On the other hand, it provides vacuum aspiration of fetal ovum. The mentioned operations result in stoppage of blood flow in branches of uterine arteries blood supplying cervix wall.

Keywords

cervical pregnancy / super-selective embolization of uterine arteries

References

[1] Ищенко А.И. Новые технологии и малоинвазивная хирургия в гинекологию. М.: «Геотар-Мед»; 2004.

[2] Корсак В.С., Коршунов М.Ю., Михайлов А.В., Исакова Э.В., Кирсанов А.А., Полянин А.А. О проблеме эктопической беременности после ЭКО. Проблемы репродукции. 1997; 3(2): 61-4.

[3] Стрижаков А.Н., Давыдов А.И., Шахламова М.Н., Белоцерковцева Л.Д. Внематочная беременность. М.: Медицина; 1998.

[4] Abusheikha N., Marcus S. Ectopic pregnancy following assisted reproductive technology. In: Brinsden P.R., ed. A textbook of in vitro fertilization and assisted reproduction. London: The Parthenon PublishingGroup; 1999: 333-42.

[5] Hofmann H.M., Urdl W., Hofl er H., Hönigl W., Tamussino K. Cervical pregnancy: case reports and current concepts in diagnosis and treatment. Arch. Gynecol. Obstet. 1987; 241(1): 63-9.

[6] Iaccarino V., Romano M. Cervical ectopic pregnancy treated with uterine arteries embolization and evacuation. A case report. Radiol Med. 1998; 96(3): 268-9.

[7] Fauconnier A., Pelage J.P., Lacombe P., Ville Y. Embolization of uterine fibroids and infertility: is a clinical trial conceivable? Gynecol. Obstet. Fertil. 2004; 32(9): 818-24.

[8] Itakura A., Okamura M., Ohta T., Mizutani S. Conservative treatment of a second trimester cervicoisthmic pregnancy diagnosed by magnetic resonance imaging. Obstet. Gynecol. 2003; 101(5 Pt 2): 1149-51.

[9] Lambert P., Marpeau L., Jannet D., Jault T., Truchet F., Safar E. et al. Cervical pregnancy: conservative treatment with primary embolization of the uterine arteries. A case report. Review of the literature. J. Gynecol. Obstet. Biol. Reprod. (Paris). 1995; 24(1): 43-7.

[10] Parente J.T., Ou C.S., Levy J., Legatt E. Cervical pregnancy analysis: a review and report of five cases. Obstet. Gynecol. 1983; 62 (1): 79-82.

[11] Jurcovic D., Hacket E., Campbell S. Diagnosis and treatment of early cervical pregnancy: a review and a report of two cases treated conservatively. Ultrasound Obstet. Gynecol. 1996; 8(6): 373-80.

[12] Monteagudo A., Tarricone N.J., Tumor-Tritsch I.E., Lerner J.P. Succesful transvaginal ultrasound-guided puncture and injection of a cervical pregnancy in a patient with simultaneous intrauterine pregnancy and a history of a previous cervical pregnancy. Ultrasound Obstet. Gynecol.1996; 8: 381-6.

[13] Sherer D.M., Lysikiewicz A., Abulafi a O. Viable cervical pregnancy managed with systemic Methotrexate, uterine artery embolization, and local tamponade with infl ated Foley catheter balloon. Am. J. Perinatol. 2003; 20(5): 263-7.

[14] Suzumori N., Katano K., Sato T., Okada J., Nakanishi T., Muto D. et al. Conservative treatment by angiographic artery embolization of an 11-week cervical pregnancy after a period of heavy bleeding. Fertil. Steril. 2003; 80(3): 617-9.

[15] Tal J., Hadad S., Gordon N., Timor-Tritsch I. Heterotopic pregnancy after ovulation induction and assisted reproductive technologies: a literature review from 1971 to 1993. Fertil. Steril. 1996; 66 (1): 1-12.

[16] Ushakov F.B., Elchalal U., Aceman P.J., Schenker J.G. Cervical pregnancy: past and Future. Obstet .Gynecol. Surv. 1997; 52 (1): 45-59.

[17] Доброхотова Ю.Э., Капранов С.А., Алиева А.А., Бобров Б.Ю. Эмболизация маточных артерий в лечении миомы матки. В кн.: Сборник научных трудов, посвященный первому выпуску Московского факультета РГМУ. М.; 2004: 129-35.

[18] Коков Л.С. Эмболизация маточных артерий - перспективный метод лечения больных лейомиомой матки. Акушерство и гинекология. 2005; 4: 35-41.

[19] Oliver J.Jr, Lance J. Selective embolization to control massive hemorrhage following pelvic surgery. Am. J. Obstet. Gynecol. 1979; 135(3): 431-2.

[20] Ravina J.H., Herbreteau D., Ciraru-Vigneron N., Bouret J.M., Houdart E., Aymard A. et al. Arterial embolisation to treat uterine myomata. Lancet. 1995; 346(8976): 671-2.

RIGHTS & PERMISSIONS

Eco-Vector