子宫动脉化疗栓塞治疗妊娠早期诊断为未破裂间质性妊娠

IF 0.4 4区 医学 Q4 OBSTETRICS & GYNECOLOGY
A. Takeda, S. Iyoshi, S. Tamauchi, W. Koike
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引用次数: 0

摘要

背景:随着间质性妊娠在妊娠早期诊断频率的增加,未破裂间质性妊娠的非手术治疗已成为一个重要问题。然而,通过放线菌素子宫动脉化疗栓塞(UACE)治疗未破裂间质性妊娠从未通过病例系列进行评估。方法:在此目的下,回顾性回顾了5年期间的电子病历记录,并提取了一系列未破裂的间质性妊娠的病例。诊断程序包括超声检查、磁共振成像(MRI)和必要时的腹腔镜检查。保守治疗方案包括UACE。当注意到血清β-hCG下降不足时,考虑额外给予甲氨蝶呤(MTX)。描述了临床特征和治疗结果。结果:在妊娠6周诊断为未破裂间质性妊娠的4例妇女中,1例在确定子宫肌层变薄后担心破裂而采用腹腔镜角质层切开术,而其他3例最初采用UACE治疗。1例近端间质妊娠仅通过MRI诊断,2例远端间质妊娠通过腹腔镜探查诊断。2例仅通过UACE治疗成功,而1例需要额外的全身MTX治疗以达到UACE后妊娠产物的解决。此后,一名患者自然受孕并顺利顺产。结论:这个小的病例系列强调UACE是一种可行的微创选择,用于治疗妊娠早期未破裂的间质性妊娠。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Uterine artery chemoembolization for management of unruptured interstitial pregnancy diagnosed in the early first trimester
Background: With the increased frequency of diagnosis of interstitial pregnancy in the early first trimester, non-surgical management of unruptured interstitial pregnancy has become an important issue. However, management of unruptured interstitial pregnancy by uterine artery chemoembolization (UACE)with dactinomycin has never been evaluated via a case series. Methods: With this aim, a retrospective review of electronic chart records over a five-year period was performed, and a series of cases of unruptured interstitial pregnancy during the first trimester was extracted. Diagnostic procedures included ultrasonography, magnetic resonance imaging (MRI), and laparoscopic examination, if necessary. Conservative treatment regimen included UACE. Additional administration of methotrexate (MTX) was considered when an insufficient decline of serum β-hCG was noted. Clinical characteristics and treatment outcomes are described. Results: Among four women diagnosed with unruptured interstitial pregnancy at six weeks of gestation, one case was managed by laparoscopic cornuostomy due to concerns of rupture after the identification of thinning of the myometrium, whereas the other three cases were initially managed by UACE. One case of proximal interstitial pregnancy was diagnosed solely by MRI, whereas two cases of distal interstitial pregnancy was diagnosed by exploratory laparoscopy. Two cases were successfully managed by UACE alone, whereas one case required additional systemic administration of MTX to achieve resolution of gestational products after UACE. Thereafter, one patient conceived spontaneously and experienced a successful vaginal birth. Conclusions: This small case series emphasizes that UACE is a feasible minimally invasive option for the management of unruptured interstitial pregnancy identified in the early first trimester.
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
241
审稿时长
1 months
期刊介绍: CEOG is an international, peer-reviewed, open access journal. CEOG covers all aspects of Obstetrics and Gynecology, including obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine. All submissions of cutting-edge advances of medical research in the area of women''s health worldwide are encouraged.
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