title: Outcomes of Bilateral Uterine Artery Chemoembolization in Combination with Surgical Evacuation or Systemic Methotrexate for Cervical Pregnancy.
abstract: OBJECTIVE
  To evaluate the use of bilateral uterine artery chemoembolization in combination with surgical evacuation or systemic methotrexate (MTX) in the conservative treatment of cervical pregnancy (CP).
  
  
  METHODS
  Clinical case series (Canadian Task Force classification II-3).
  
  
  METHODS
  Tertiary university hospital.
  
  
  METHODS
  Women with a CP who were treated at West China Second University Hospital of Sichuan University between January 2006 and January 2013.
  
  
  METHODS
  Bilateral uterine artery chemoembolization in combination with surgical evacuation or systemic MTX.
  
  
  RESULTS
  β-Human chorionic gonadotropin (β-hCG), cervical mass, blood transfusion, length of hospital stay, future menstruation, and fertility were assessed. Thirty-nine patients were successfully treated by chemoembolization in combination with surgical evacuation or systemic MTX. All massive bleeding was controlled after chemoembolization, and the 35 subsequent evacuation surgeries were uneventful. Nine patients received blood transfusions. The time for serum β-hCG normalization was 28.7 ± 9.8 days (range, 7-60). The time for CP mass disappearance by ultrasonography was 27.0 ± 6.9 days (range, 11-48) days. The length of hospital stay was 7.7 ± 4.9 days (range, 3-33). Complications were mainly fever and pain, which were alleviated with symptomatic treatment. Thiry-eight patients had recovered their normal menstruation, and 7 patients had future pregnancies at follow-up.
  
  
  CONCLUSIONS
  Bilateral uterine artery chemoembolization is effective in controlling and preventing massive hemorrhage associated with CP. It is proved to treat CP with optimal recovery time, few outpatient follow-ups, and efficient fertility preservation when combined with surgical evacuation or systemic MTX.
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Hengxi
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Shiyuan
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Fu
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, People's Republic of China. Electronic address: weihuang64@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Heng
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000328:Adult; D002584:Cervix Uteri; D016461:Chemoembolization, Therapeutic; D002681:China / Q000453:epidemiology; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D003131:Combined Modality Therapy; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055988:Uterine Artery / Q000601:surgery*; D055357:Uterine Artery Embolization
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate
keywords: Cervical pregnancy; Methotrexate; Uterine artery chemoembolization