Therapeutic Outcomes of Patients with Cervical and Incisional Ectopic Pregnancies and Venous and Arterial Malformations Treated with Uterine Artery Embolization, Methotrexate, and Curettage: A Descriptive Cross-Sectional Study
نویسندگان
1 Department of Gynecology Oncology, School of Medicine, Reproductive Health Research Center, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
2 Department of Obstetrics and Gynecology, Reproductive Health Research Center, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
3 Department of Gynecology Oncology, School of Medicine, Reproductive Health Research Center, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
4 Department of Gynecology Oncology, School of Medicine, Reproductive Health Research Center, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
5 Department of Epidemiology, Vice-Chancellorship of Research and Technology, Guilan University of Medical Science, Rasht, Iran
6 Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
7 Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
doi
10.24200/jogcr.10.10.733چکیده
Background & Objective: One of the leading causes of death for women of reproductive age is blastocyst implantation outside the uterus, an Ectopic Pregnancy (EP). This study describes and investigates the therapeutic outcomes of patients with cervical and incisional EP and arteriovenous malformation treated with Uterine Artery Embolization (UAE), methotrexate, and curettage.Materials & Methods: In this descriptive cross-sectional study, 166 patients aged 18 to 45 with cervical and incisional EP and Arteriovenous Malformation (AVM) were treated with UAE, methotrexate systemic administration, and curettage. To perform uterine embolization, non-absorbable particles of trisacryl gelatin (Embosphere) with a diameter between 300 and 900 micrometers were used to close the ascending branch of the uterine artery wholly and partially keep the main branch and its cervical branch open.Results: Most patients had ectopic and incisional pregnancies (77.1%). The frequencies of cervical ectopic pregnancy and uterine arterial-venous malformation were 16.3% and 6.6%, respectively. The UAE and curettage frequencies were 49.4% and 63.3%, respectively. The frequency of hysterectomy was reported in only two patients (1.2%). The frequency of wedge resection was also reported in 33 patients (19.9%).Conclusion: This study emphasizes the need for improving the quality of the subsequent pregnancy along with side treatments for incisional and cervical ectopic pregnancies with AVM and suggests that UAE can be a promising method
