Successful conservative treatment of cervical pregnancy with uterine artery embolization followed by curettage: a report of 19 cases.

Abstract

The purpose of this retrospective study was to evaluate the safety and efficacy of uterine artery embolization (UAE) followed by curettage for conservative management of cervical pregnancy. Retrospective review. Peking University First Hospital. Patients with cervical pregnancy diagnosed by trans-vaginal ultrasound at Peking University First Hospital between January 2003 and December 2014. We retrospectively reviewed the clinical background and outcomes of patients with cervical pregnancy who underwent UAE followed by curettage for prevention of massive vaginal bleeding and removal of gestational tissue from the cervix. We also reviewed the literature on the role of UAE in the treatment of cervical pregnancy. Clinical assessments included gestational age, gravidity, endocervical canal mass, serum beta-human chorionic gonadotrophin (β-HCG) level, blood loss, hospitalisation stay and expenses, time of resumption of menstruation and subsequent pregnancy outcomes. A total of 19 patients with cervical pregnancy treated with UAE followed by curettage were identified. Curettage was performed 24-72hours after UAE in 16 patients, within 24hours after UAE in three patients. None of the patients underwent a hysterectomy as a result of cervical pregnancy. Of the nine patients with available follow-up information (median follow-up time 59months), eight resumed normal menstruation and one had a term pregnancy with a normal vaginal delivery. Quick regression of serum β-HCG level, low blood loss and short hospital stay were observed. UAE combined with curettage is a safe, effective and fertility-sparing choice for treatment of patients with cervical pregnancy. A serial of 19 patients with cervical pregnancy treated with UAE followed by curettage showed a good prognosis.