Su Y N, Shih J C, Chiu W H, Lee C N, Cheng W F, Hsieh F J
Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Ultrasound Obstet Gynecol. 1999 Oct;14(4):284-7. doi: 10.1046/j.1469-0705.1999.14040284.x.
Cervical pregnancy is frequently associated with extensive hemorrhage which, in severe cases, may be stopped only by hysterectomy. We report a case of an anembryonic cervical pregnancy diagnosed at 10 weeks, and associated with a large arteriovenous malformation. The patient was conservatively managed with simple selective uterine artery embolization. After embolization, her vaginal bleeding ceased and the level of serum beta-human chorionic gonadotropin decreased rapidly. No additional treatment was given. The patient's postoperative course was uneventful and the cervical mass had disappeared at the follow-up 4 months later. To the best of our knowledge, this is the first report of conservative management of cervical pregnancy simply by uterine artery embolization. The role of three-dimensional power Doppler ultrasonography in the assessment of cervical pregnancy and in monitoring the therapeutic response is discussed.
宫颈妊娠常伴有大量出血,严重时可能只有通过子宫切除术才能止血。我们报告一例孕10周诊断为胚胎停育的宫颈妊娠病例,该病例伴有一个大的动静脉畸形。患者接受了单纯选择性子宫动脉栓塞的保守治疗。栓塞后,她的阴道出血停止,血清β-人绒毛膜促性腺激素水平迅速下降。未给予其他治疗。患者术后恢复顺利,4个月后的随访中宫颈肿块已消失。据我们所知,这是首例仅通过子宫动脉栓塞对宫颈妊娠进行保守治疗的报告。本文还讨论了三维能量多普勒超声在评估宫颈妊娠及监测治疗反应中的作用。