Szmygin Maciej, Kłobuszewski Bartosz, Nieoczym Karolina, Dymara-Konopka Weronika, Woźniak Sławomir, Szmygin Hanna, Światłowski Łukasz, Pyra Krzysztof
Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.
Department of Oncology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.
Diagnostics (Basel). 2025 Aug 4;15(15):1956. doi: 10.3390/diagnostics15151956.
: Cervical pregnancy (CP) accounts for less than 1% of all ectopic pregnancies. The standard of management for CP is still under detailed investigation; however, among the known treatment methods, super-selective uterine artery embolization (UAE) and the use of methotrexate (MTX) have emerged as effective and minimally invasive options in recent years. Our aim is to present our center's experience and provide available evidence evaluating the efficacy of UAE in the treatment of CP. This single-center and retrospective study evaluated the procedural and clinical outcomes of patients with CP who underwent endovascular uterine embolization with MTX between 2017 and 2024. Both procedural and clinical efficacy and safety, as well as the rate of complications and long-term outcomes, were noted. A total of nine patients were diagnosed with CP (imaging examination included transvaginal ultrasound and/or magnetic resonance imaging) and referred for endovascular treatment. The mean age of the patients was 36.7 years, and the mean gestational age on admission was 9 weeks. In all cases, selective catheterization of supplying vessels and subsequent embolization with a mixture of methotrexate and gel sponge was carried out. The technical success rate was 100% with no complications. Follow-up ultrasound confirmed the disappearance of the flow signal around the intracervical gestational sac in all cases. In conclusion, this retrospective study demonstrated the procedural and clinical safety and efficacy of uterine artery embolization in patients with cervical pregnancy. This is why endovascular therapy should be proposed to these individuals and be included in treatment options discussed during multidisciplinary boards.
宫颈妊娠（CP）占所有异位妊娠的比例不到1%。CP的管理标准仍在详细研究中；然而，在已知的治疗方法中，近年来超选择性子宫动脉栓塞术（UAE）和甲氨蝶呤（MTX）的使用已成为有效且微创的选择。我们的目的是介绍我们中心的经验，并提供评估UAE治疗CP疗效的现有证据。这项单中心回顾性研究评估了2017年至2024年间接受MTX血管内子宫栓塞术的CP患者的手术和临床结果。记录了手术和临床疗效及安全性，以及并发症发生率和长期结果。共有9例患者被诊断为CP（影像学检查包括经阴道超声和/或磁共振成像）并转诊接受血管内治疗。患者的平均年龄为36.7岁，入院时的平均孕周为9周。所有病例均进行了供血血管的选择性插管，随后用甲氨蝶呤和明胶海绵混合物进行栓塞。技术成功率为100%，无并发症。随访超声证实所有病例宫颈妊娠囊周围的血流信号均消失。总之，这项回顾性研究证明了子宫动脉栓塞术在宫颈妊娠患者中的手术和临床安全性及有效性。这就是为什么应向这些患者建议血管内治疗，并将其纳入多学科讨论的治疗选择中。
