title: Interventional radiology and endovascular surgery in the treatment of ectopic pregnancies.
abstract: The advent of interventional radiology enabled remarkable advances in diagnosis and treatment of several situations in obstetrics and gynecology. In the field of obstetrics, these advances include temporary occlusion of the iliac arteries to the management of placenta accreta and/or prior, arteriovenous fistulas after embolization of uterine curettage and management of ectopic uterine and extra-uterine pregnancies. The non-tubal ectopic pregnancy, either cervical, abdominal, ovarian or in a cesarean scar, often represents major therapeutic challenge, especially when exists a desire to maintain fertility. Despite the systemic methotrexate therapy and surgical resection of the ectopic gestational sac be the most used therapeutic options, the interventionist approach of non-tubal ectopic pregnancies, direct injection of methotrexate in the gestational sac and intra-arterial chemoembolization of uterine arteries constitute in the currently literature viable, safe, effective modalities with low morbidity, shorter hospital stay, and rapid clinical recovery. Because of little variety of materials used, and the increase in training of specialists in the area, the radiological intervention as a treatment option in ectopic pregnancies is financially viable and present considerable accessibility in the world and at most of Brazilian medical centers.
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Vinicius Adami Vayego
authors.initials: VA
authors.lastname: Fornazari
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Denis
authors.initials: D
authors.lastname: Szejnfeld
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Julio
authors.initials: J
authors.lastname: Elito Júnior
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Suzan Menasce
authors.initials: SM
authors.lastname: Goldman
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D016461:Chemoembolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000628:therapy*; D015642:Radiology, Interventional / Q000379:methods*; D055988:Uterine Artery / Q000601:surgery*; D055357:Uterine Artery Embolization / Q000379:methods
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate