Xu Bing, Wang Yan-Kui, Zhang Yong-Hua, Wang Song, Yang Ling, Dai Shu-Zhen
Department of Obstetrics and Gynecology, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China.
J Obstet Gynaecol Res. 2007 Apr;33(2):190-4. doi: 10.1111/j.1447-0756.2007.00512.x.
Two cases of cervical pregnancy with heavy bleeding successfully treated by uterine artery embolization (UAE) followed by immediate curettage are described in this report. Case 1 demonstrated intermittent bleeding after serious bleeding was successfully controlled by UAE. Serum beta human chorionic gonadotropin (beta-hCG) level rose remarkably after a short time decline. Transvaginal sonography consistently revealed a heterogeneous mass in the cervix. Repeated UAE followed by immediate curettage was performed and complete resolution was achieved. Case 2 was also successfully managed by UAE followed by immediate curettage after failure of medical treatment. This report suggests that UAE followed by immediate curettage is a safe and efficient procedure for controlling heavy bleeding and avoiding recurrent bleeding when fertility capacity is desired in cases of cervical pregnancy with fetal cardiac activity and high beta-hCG concentration.
本报告描述了两例宫颈妊娠伴大量出血的病例,通过子宫动脉栓塞术(UAE)成功治疗后立即刮宫。病例1在UAE成功控制严重出血后出现间歇性出血。血清β-人绒毛膜促性腺激素(β-hCG)水平在短暂下降后显著上升。经阴道超声检查持续显示宫颈内有不均匀肿块。重复进行UAE后立即刮宫,最终完全治愈。病例2在药物治疗失败后,同样通过UAE并立即刮宫成功治疗。本报告表明,对于有胎心活动且β-hCG浓度高的宫颈妊娠病例,若希望保留生育能力,UAE后立即刮宫是控制大量出血和避免反复出血的一种安全有效的方法。