scholarly journals Successful term pregnancy after uterine artery embolization for caesarean scar ectopic pregnancy: a case report

2018 ◽  
Vol 7 (9) ◽  
pp. 3877
Author(s):  
Angeline Job ◽  
Spandana S.
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Comprehensive Treatment ◽  
Artery Embolization ◽  
Caesarean Scar ◽  
Caesarean Scar Pregnancy ◽  
Future Pregnancy

The incidence of caesarean scar pregnancy range from 1 in 1800 to 1 in 2500 of all pregnancies. It has been estimated that 6.1% of pregnancies in women with at least one previous Caesarean section and a diagnosis of ectopic pregnancy will be Caesarean scar pregnancy (CSP). There is no consensus on the management of CSP. An invasive intervention such as excision of scar ectopic can reduce recurrence but affects patient’s fertility. Conservative management like administration of methotrexate and uterine artery embolization (UAE) is specially important for young women who want to keep their fertility. This is a case report of a 29-year-old woman who presented with persistent heavy bleeding following failed MTP at 12 weeks of gestation. Ultrasonogarphy was suggestive of Caesarean scar pregnancy and MRI of chronic left adnexal ectopic. Laparotomy also was suggestive of Caesarean scar ectopic. She was managed conservatively with UAE followed by Methotrexate. The procedure was performed successfully, and the patient’s fertility was preserved. Follow up consisted of serial bhCG monitoring which gradually returned to normal levels. She conceived four years after UAE and had an uneventful antenatal period and underwent Elective Cesaraen section at 38 weeks. For those patients with CSP who desire future pregnancy, the comprehensive treatment including UAE can be considered in management.

Uterine Artery Embolization and Methotrexate Infusion as Sole Management for Caesarean Scar and Cervical Ectopic Pregnancies: A Single-Center Experience and Literature Review

2019 ◽  
Vol 70 (3) ◽  
pp. 307-316 ◽  
Author(s):  
Ali H. Elmokadem ◽  
Rihame M. Abdel-Wahab ◽  
Ahmed A. El-Zayadi ◽  
Mohamed M. Elrakhawy
Keyword(s):  
Literature Review ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Clinical Results ◽  
Artery Embolization ◽  
Caesarean Scar ◽  
Single Center Experience ◽  
Ectopic Pregnancies ◽  
Age Range

Introduction The incidence of caesarean scar pregnancy (CSP) and cervical pregnancy (CP) has increased significantly in recent years. The related hemorrhage can be lethal and often needs hysterectomy. This study aims to assess the technical and clinical results of uterine artery embolization (UAE) combined with intra-arterial methotrexate (MTX) infusion for CSP and CP. Methods A retrospective study was conducted for 11 patients (age range from 25–40 years, mean; 31.8 y) with CSP (7/11) and CP (4/11). The diagnosis was confirmed by elevated b-hCG levels (mean 31.245 mIU/mL) with sonography and/or magnetic resonance imaging. They were treated with UAE using particulate embolic material. In all patients, the infusion of MTX (50 mg/m2) was performed before UAE. Follow-up periods after UAE ranged between 6-24 months included weekly sonography and b-hCG level assessment. A literature review was performed using standard online search tools. Results In 10 patients, UAE controlled active vaginal bleeding and reduced post-procedural b-hCG levels significantly by the second week. One patient presented with persistent elevated b-hCG level and vaginal rebleeding. The rebleeding was successfully controlled by second UAE procedure. The ectopic pregnancies were resolved, and the uterus was preserved in all patients. No major complications were detected. Normal menses resumed within 2 months after UAE. Two patients had subsequent natural successful intrauterine pregnancies. Conclusion 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.

scholarly journals A Second Trimester Caesarean Scar Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Pooja Sikka ◽  
Vanita Suri ◽  
Seema Chopra ◽  
Neelam Aggarwal
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Rare Entity ◽  
Second Trimester ◽  
Artery Embolization ◽  
Caesarean Scar ◽  
Caesarean Scar Pregnancy

Caesarean scar pregnancy, where conceptus is implanted on previous scar, is a rare entity. We present one such case of scar pregnancy presenting to us in the second trimester and was managed with methotrexate and uterine artery embolization, followed by hysterotomy. Uterus could be conserved and hysterectomy could be avoided.

scholarly journals Sepsis after uterine artery embolization-assisted termination of pregnancy with complete placenta previa: A case report

2017 ◽  
Vol 46 (1) ◽  
pp. 546-550 ◽  
Author(s):  
Yinfeng Wang ◽  
Xiufeng Huang
Keyword(s):  
Severe Sepsis ◽  
Case Report ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Placenta Previa ◽  
Termination Of Pregnancy ◽  
High Grade ◽  
Artery Embolization ◽  
High Grade Fever ◽  
Emergency Cesarean

Uterine artery embolization (UAE)-assisted induction of labor is an alternative method of managing pregnant women with complete placenta previa (CPP). Sepsis secondary to UAE, although rare, is a serious complication. We herein present a case of severe sepsis following UAE-assisted termination of a pregnancy at 27 gestational weeks in a woman with CPP. The woman developed a high-grade fever and elevated inflammatory indices following UAE. She did not recover until the infected tissue was removed by emergency cesarean section. This case suggests that the increasing use of UAE for termination of pregnancy in women with CPP requires awareness regarding the possibility of serious sepsis associated with this procedure.

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