Uterine artery chemoembolisation: its application in treating C-section scar pregnancy

Congress:

ECR 2011

Poster Number:

C-0933

Type:

Scientific Paper

Keywords:

Authors:

G. Zhang, S. Gu, T. Wang, Z. Han; Shanghai/CN

DOI:

10.1594/ecr2011/C-0933

DOI-Link:

https://dx.doi.org/10.1594/ecr2011/C-0933

Fig. 1: A 29-year-old womam with irregular vaginal bleeding whose right uterine artery...

Fig. 2: Arteriovenous fistula and placent staining can be seen in the late phase of...

Fig. 3: In the same patient, the right uterine artery was occluded after MTX infused...

Fig. 4: In the arterial phase of angiography of the same patient, the left uterine was...

Fig. 5: Arteriovenous fistula, placent staining can be seen in the late phase of...

Fig. 6: In the same patient,the left uterine artery was occluded after MTX infused and...

Purpose

To discuss the efficacy and safety of uterine artery chemoembolization in treatment of Cesarean-section scar pregnancy.

Methods and Materials

During the period of Jun, 2005-Jun, 2010, uterine artery chemoembolization was performed in 130 patients with C-section scar pregnancy in our hospital. Via bilateral uterine arteries,100-150mg MTX and 80000 U Gentamycin were infused separately, after that, the bilateral uterine arteries were embolized with gelfoam particles to slow down the blood flow and then bars of gelfoam to block blood flow. Among all the patients, 23 cases of them who were combined with leiomyoma were embolized with PVA instead of gelfoam. Curettage of uterus was carried...

Results

The success rate of embolism operation was 100%. And the success rate of curettage combined with the first time embolism operation is 96.92%（126/130）（The blood loss was between 12-110 milliliters (mean 28.5ml) during the procedure of curettage）. The other 4 cases(4/130) whose embryonic month were large and combined with arteriovenous fistula were still rich in blood supply after the first embolism operation which were proved by ultrasound examination, need a second embolism operation 2 weeks later after the first time embolism operation.（The blood loss was between100-150ml...

Conclusion

The uterine artery chemoembolization is an effective and safe treatment for C-section scar pregnancy, which can greatly reduce the risk of hysterectomy and preserve fertility of the pregnant women.

References

[1] Jurkovic D, Hillaby K, Woelfer B, et al. First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar [J]. Ultrasound Obstet Gynecol,2003,21:220. [2] Seow KM, Huang LW, Lin YH, et al. Cesarean scar pregnancy: issues in management [J]. Ultrasound Obstet Gynecol, 2004, 23:247. [3] McKenna DA,Poder L,Goldman M,et al.Role of Sonography in the Recognition, Assessment, and Treatment of Cesarean Scar Ectopic Pregnancies [J]. Ultrasound Med,2008, 27: 779 - 783. [4] Maymon R, Halperin1 R, Mendlovic S, et al. Ectopic...

Personal Information

ZHANG Guo-fu, Liu-jia, WANG Tian-ping, GU Shou-xin, HAN Zhi-gang, ZHANG Di, Wang Shijia, TIAN Xiao-mei, WANG Xue-zhen. Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China Corresponding author: ZHANG Guofu, MD. email: [email protected]