Safety and Efficacy of Uterine Artery Embolization in Ectopic Pregnancies Refractory to Systemic Methotrexate Treatment: A Single-Center Study

Joon Ho Kwon, Gyoung Min Kim, Kichang Han, Man Deuk Kim, Jong Yun Won, Do Yun Lee

Research output: Contribution to journalArticle

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Abstract

Background: To investigate the use of uterine artery embolization (UAE) to manage ectopic pregnancies that are refractory to systemic methotrexate (MTX) therapy and plagued by persistently high serum β-human chorionic gonadotrophin (hCG) levels and vaginal bleeding. The safety and efficacy of UAE were addressed. Materials and Methods: A retrospective review was conducted for thirteen patients (mean age 35.2 years; range 28–41 years), who were treated between December 2006 and June 2016. Each was subjected to UAE due to persistently high serum β-hCG levels and vaginal bleeding after systemic MTX therapy for ectopic pregnancy. Embolic agents used were non-spherical polyvinyl alcohol or gelatin sponge particles. Post-treatment follow-up was performed by monitoring for clinical signs of vaginal bleeding, serum β-hCG testing, and transvaginal US. Outcomes were technical success, clinical success, and complications. Results: Median follow-up period was 172.5 days (range 30–600 days). Technical success was achieved in all 13 patients (100%). In 10 patients, vaginal bleeding resolved after one UAE attempt (clinical success 76.0%). Rebleeding in other three (23.1%) was controlled through repeat UAE. Seven patients (53.8%) had additional dilatation and curettage to remove gestational sac remnants. All ectopic pregnancies were successfully treated by UAE, with normalization of serum β-hCG levels during follow-up monitoring (P = 0.01). Uterine preservation was achieved in all 13 patients, without major procedural complications. Conclusion: UAE appears safe and effective as treatment of ectopic pregnancies marked by persistently high serum β-hCG levels and vaginal bleeding after systemic MTX treatment.

Original languageEnglish
Pages (from-to)1351-1357
Number of pages7
JournalCardiovascular and interventional radiology
Volume40
Issue number9
DOIs
Publication statusPublished - 2017 Sep 1

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Uterine Artery Embolization
Ectopic Pregnancy
Methotrexate
Uterine Hemorrhage
Chorionic Gonadotropin
Safety
Serum
Therapeutics
Gestational Sac
Polyvinyl Alcohol
Dilatation and Curettage
Porifera
Gelatin

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{561cf4c0260c4613b10b264f97bd56c9,
title = "Safety and Efficacy of Uterine Artery Embolization in Ectopic Pregnancies Refractory to Systemic Methotrexate Treatment: A Single-Center Study",
abstract = "Background: To investigate the use of uterine artery embolization (UAE) to manage ectopic pregnancies that are refractory to systemic methotrexate (MTX) therapy and plagued by persistently high serum β-human chorionic gonadotrophin (hCG) levels and vaginal bleeding. The safety and efficacy of UAE were addressed. Materials and Methods: A retrospective review was conducted for thirteen patients (mean age 35.2 years; range 28–41 years), who were treated between December 2006 and June 2016. Each was subjected to UAE due to persistently high serum β-hCG levels and vaginal bleeding after systemic MTX therapy for ectopic pregnancy. Embolic agents used were non-spherical polyvinyl alcohol or gelatin sponge particles. Post-treatment follow-up was performed by monitoring for clinical signs of vaginal bleeding, serum β-hCG testing, and transvaginal US. Outcomes were technical success, clinical success, and complications. Results: Median follow-up period was 172.5 days (range 30–600 days). Technical success was achieved in all 13 patients (100{\%}). In 10 patients, vaginal bleeding resolved after one UAE attempt (clinical success 76.0{\%}). Rebleeding in other three (23.1{\%}) was controlled through repeat UAE. Seven patients (53.8{\%}) had additional dilatation and curettage to remove gestational sac remnants. All ectopic pregnancies were successfully treated by UAE, with normalization of serum β-hCG levels during follow-up monitoring (P = 0.01). Uterine preservation was achieved in all 13 patients, without major procedural complications. Conclusion: UAE appears safe and effective as treatment of ectopic pregnancies marked by persistently high serum β-hCG levels and vaginal bleeding after systemic MTX treatment.",
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Safety and Efficacy of Uterine Artery Embolization in Ectopic Pregnancies Refractory to Systemic Methotrexate Treatment : A Single-Center Study. / Kwon, Joon Ho; Kim, Gyoung Min; Han, Kichang; Kim, Man Deuk; Won, Jong Yun; Lee, Do Yun.

In: Cardiovascular and interventional radiology, Vol. 40, No. 9, 01.09.2017, p. 1351-1357.

Research output: Contribution to journalArticle

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T2 - A Single-Center Study

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AU - Lee, Do Yun

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N2 - Background: To investigate the use of uterine artery embolization (UAE) to manage ectopic pregnancies that are refractory to systemic methotrexate (MTX) therapy and plagued by persistently high serum β-human chorionic gonadotrophin (hCG) levels and vaginal bleeding. The safety and efficacy of UAE were addressed. Materials and Methods: A retrospective review was conducted for thirteen patients (mean age 35.2 years; range 28–41 years), who were treated between December 2006 and June 2016. Each was subjected to UAE due to persistently high serum β-hCG levels and vaginal bleeding after systemic MTX therapy for ectopic pregnancy. Embolic agents used were non-spherical polyvinyl alcohol or gelatin sponge particles. Post-treatment follow-up was performed by monitoring for clinical signs of vaginal bleeding, serum β-hCG testing, and transvaginal US. Outcomes were technical success, clinical success, and complications. Results: Median follow-up period was 172.5 days (range 30–600 days). Technical success was achieved in all 13 patients (100%). In 10 patients, vaginal bleeding resolved after one UAE attempt (clinical success 76.0%). Rebleeding in other three (23.1%) was controlled through repeat UAE. Seven patients (53.8%) had additional dilatation and curettage to remove gestational sac remnants. All ectopic pregnancies were successfully treated by UAE, with normalization of serum β-hCG levels during follow-up monitoring (P = 0.01). Uterine preservation was achieved in all 13 patients, without major procedural complications. Conclusion: UAE appears safe and effective as treatment of ectopic pregnancies marked by persistently high serum β-hCG levels and vaginal bleeding after systemic MTX treatment.

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