Therapeutic outcomes of patients with cervical and incisional ectopic pregnancies and venous, arterial malformations treated with uterine artery embolisation, methotrexate and curettage: a descriptive cross-sectional study

Background and Objective: One of the leading causes of death for women of reproductive age is blastocyst implantation outside the uterine, an ectopic pregnancy (EP). This study describes and investigates the therapeutic outcomes of patients with cervical and incisional EP and arteriovenous malformation, treated with uterine artery embolisation (UAE), methotrexate and curettage.Methods: In this descriptive cross-sectional study, ۱۶۶ patients aged ۱۸ to ۴۵ with cervical and incisional EP and arteriovenous malformation (AVM) were treated with UAE, methotrexate systemic administration and curettage. To perform uterine embolisation, non-absorbable particles of trisacryl gelatin (Embosphere) with a diameter between ۳۰۰ and ۹۰۰ micrometres were used to close the ascending branch of the uterine artery wholly and partially keep the main branch and its cervical branch open.Results: Most patients had ectopic and incisional pregnancies (۷۷.۱%). The frequencies of cervical ectopic pregnancy and uterine arterial-venous malformation were ۱۶.۳% and ۶.۶%, respectively. The UAE and curettage frequencies were ۴۹.۴% and ۶۳.۳%, respectively. The frequency of hysterectomy was reported in only two patients (۱.۲%). The frequency of wedge resection was also reported in ۳۳ patients (۱۹.۹%).Conclusion: This study emphasizes the need for improving the quality of the subsequent pregnancy along with side treatments for incisional and cervical ectopic pregnancies with AVM and suggests that UAE can be a promising method.

Keywords:

Incisional and cervical ectopic pregnancies , AVM , Menstrual Cycle , UAE