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Laparoscopic uterine artery occlusion before cervical curettage in cervical ectopic pregnancy: Safe and effective for preventing massive bleeding.

Choi HS, Kim NY, Ji YI - Obstet Gynecol Sci (2015)

Bottom Line: Cervical ectopic pregnancy is associated with high risk for massive bleeding conditions.We present 4 cases of cervical ectopic pregnancy that were treated successfully with different uterine-conserving methods.By comparing our experience of 4 cases managed in different ways, we found that laparoscopic uterine artery occlusion before cervical curettage is more effective method for preventing massive bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Pusan, Korea.

ABSTRACT
Cervical ectopic pregnancy is associated with high risk for massive bleeding conditions. Cervical ectopic pregnancy can usually be treated by methotrexate injection or surgery. We present 4 cases of cervical ectopic pregnancy that were treated successfully with different uterine-conserving methods. By comparing our experience of 4 cases managed in different ways, we found that laparoscopic uterine artery occlusion before cervical curettage is more effective method for preventing massive bleeding.

No MeSH data available.


Related in: MedlinePlus

Laparoscopic uterine artery occlusion before cervical curettage.
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Figure 1: Laparoscopic uterine artery occlusion before cervical curettage.

Mentions: In this patient, surgical curettage of a cervical ectopic pregnancy was performed after medical treatment failed. The pregnancy was at gestational 6 weeks, and initial serum B-hCG level was 28,752.5 mIU/mL. Although intramuscular MTX was injected once with dose of which based on a 50 mg/m2 body surface area, the patient's serum B-hCG level increased to 35,439 mIU/mL after 1 week. Vaginal bleeding persisted and increased. To surgically remove the ectopic mass and for bleeding control, LUAO was performed before cervical curettage. Access to the uterine arteries on both right and left sides laparoscopically, and hemostatic clips were applied (Fig. 1). After clipping both uterine arteries, cervical curettage was performed as usual. The estimated intraoperative and postoperative blood loss was 40 mL. After 24 hours, bleeding had stopped. After 1 week, serum B-hCG level decreased to 69.2 mIU/mL, and after 3 weeks, the levels reached 0 mIU/mL. Abnormal vaginal bleeding was not seen after surgery, until 3-month follow-ups.


Laparoscopic uterine artery occlusion before cervical curettage in cervical ectopic pregnancy: Safe and effective for preventing massive bleeding.

Choi HS, Kim NY, Ji YI - Obstet Gynecol Sci (2015)

Laparoscopic uterine artery occlusion before cervical curettage.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588853&req=5

Figure 1: Laparoscopic uterine artery occlusion before cervical curettage.
Mentions: In this patient, surgical curettage of a cervical ectopic pregnancy was performed after medical treatment failed. The pregnancy was at gestational 6 weeks, and initial serum B-hCG level was 28,752.5 mIU/mL. Although intramuscular MTX was injected once with dose of which based on a 50 mg/m2 body surface area, the patient's serum B-hCG level increased to 35,439 mIU/mL after 1 week. Vaginal bleeding persisted and increased. To surgically remove the ectopic mass and for bleeding control, LUAO was performed before cervical curettage. Access to the uterine arteries on both right and left sides laparoscopically, and hemostatic clips were applied (Fig. 1). After clipping both uterine arteries, cervical curettage was performed as usual. The estimated intraoperative and postoperative blood loss was 40 mL. After 24 hours, bleeding had stopped. After 1 week, serum B-hCG level decreased to 69.2 mIU/mL, and after 3 weeks, the levels reached 0 mIU/mL. Abnormal vaginal bleeding was not seen after surgery, until 3-month follow-ups.

Bottom Line: Cervical ectopic pregnancy is associated with high risk for massive bleeding conditions.We present 4 cases of cervical ectopic pregnancy that were treated successfully with different uterine-conserving methods.By comparing our experience of 4 cases managed in different ways, we found that laparoscopic uterine artery occlusion before cervical curettage is more effective method for preventing massive bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Pusan, Korea.

ABSTRACT
Cervical ectopic pregnancy is associated with high risk for massive bleeding conditions. Cervical ectopic pregnancy can usually be treated by methotrexate injection or surgery. We present 4 cases of cervical ectopic pregnancy that were treated successfully with different uterine-conserving methods. By comparing our experience of 4 cases managed in different ways, we found that laparoscopic uterine artery occlusion before cervical curettage is more effective method for preventing massive bleeding.

No MeSH data available.


Related in: MedlinePlus