Bhinder Khurram Khaliq, Sarfraz Azza, Sarfraz Zouina, Riaz Shaista, Aslam Samreen, Ameena Zouina
Shifa International Hospital, Islamabad, Pakistan.
The Aga Khan University, Karachi, Pakistan.
Radiol Case Rep. 2021 Jun 15;16(8):2248-2251. doi: 10.1016/j.radcr.2021.05.032. eCollection 2021 Aug.
We present the case of 30-year old primigravida female at 11 weeks' gestation who was diagnosed to have ectopic pregnancy on obstetric ultrasound. An MRI pelvis was ordered to assess invasion into the posterior myometrium which confirmed a single right-sided broad ligament-extra uterine pelvic ectopic pregnancy with extrinsic mass effect on the right lower uterine segment without frank myometrial invasion. On an urgent basis, a uterine artery embolization (UAE) was performed by targeting the right femoral artery. Selective catheterization was performed of both uterine arteries and the right side showed a major feeder of the gestational sac. Supplied dose of methotrexate (95mg) was infused in the right uterine artery and both arteries were then embolized by gel foam slurry. Thus, prompt treatment reduced the risk of infertility and saved the patient from obstetrical emergency. Further exploration needs to be done in this field to explore conservative management options to preserve fertility.
我们报告一例30岁初产妇，孕11周，经产科超声诊断为异位妊娠。行盆腔MRI检查以评估对子宫后壁肌层的侵犯情况，结果证实为右侧阔韧带-子宫外盆腔单发性异位妊娠，对子宫下段右侧有外在肿块效应，但无明显子宫肌层侵犯。在紧急情况下，通过靶向右侧股动脉进行了子宫动脉栓塞术（UAE）。对双侧子宫动脉进行了选择性插管，右侧显示为妊娠囊的主要供血支。将95mg甲氨蝶呤的给药剂量注入右侧子宫动脉，然后用明胶海绵浆液栓塞双侧动脉。因此，及时的治疗降低了不孕风险，使患者免于产科急症。该领域需要进一步探索以寻求保留生育能力的保守治疗方案。
