Ortiz Ginna, Kameyama Nicolas, Sulaiman Jean Paul, Lopez-Bayghen Esther
Investigación Clínica, Instituto de Infertilidad y Genética México SC, Ingenes, México City, México.
Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), México City, México.
J Surg Case Rep. 2021 May 27;2021(5):rjab216. doi: 10.1093/jscr/rjab216. eCollection 2021 May.
If methotrexate (MTX) fails to resolve cervical ectopic pregnancies (CEP), the remaining surgical options result in the potential loss of the patient's fertility. Therefore, we examined if the embryo reduction technique can resolve the CEP without any complications while conserving the patient's fertility. We report three cases in which CEP didn't respond to MTX but was successfully solved by embryo reduction. Each patient underwent a standard fertilization (IVF) protocol. Once CEP was confirmed, the pregnancy's location, the fetus's size and gestational sac and heartbeat were determined. Afterward, embryo reduction was performed under general anesthesia (operative time: ~30 min). All patients had successful procedures without any postoperative complications. Since the procedure, one woman was pregnant and delivered, the second has registered a positive β-human chorionic gonadotropin test and the last is waiting for IVF preparation. In summary, embryo reduction is a feasible approach in the management of CEP with favorable fertility outcomes.
如果甲氨蝶呤（MTX）无法解决宫颈异位妊娠（CEP），其余的手术选择可能会导致患者丧失生育能力。因此，我们研究了胚胎减灭技术是否可以在不引发任何并发症的情况下解决CEP，同时保留患者的生育能力。我们报告了三例CEP对MTX无反应但通过胚胎减灭成功解决的病例。每位患者均接受了标准的体外受精（IVF）方案。一旦确诊为CEP，便确定妊娠位置、胎儿大小、妊娠囊及心跳情况。之后，在全身麻醉下进行胚胎减灭（手术时间：约30分钟）。所有患者手术均成功，且无任何术后并发症。自该手术以来，一名女性已怀孕并分娩，第二名女性β-人绒毛膜促性腺激素检测呈阳性，最后一名女性正在等待IVF准备。总之，胚胎减灭是管理CEP的一种可行方法，生育结局良好。
