The treatment of tubal pregnancy by MTX drug perfusion and vascular embolization
- VernacularTitle:子宫动脉插管氨甲蝶呤灌注及动脉栓塞治疗输卵管妊娠
- Author:
Jian DA
;
Yaojun KE
;
Wei TAN
- Publication Type:Journal Article
- Keywords:
Radiology, interventional;
Pregnancy, oviduct;
Methotrexate;
Embolization, therapeutic
- From:
Chinese Journal of Radiology
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the feasibility of the treatment of tubule pregnancy by interventional technique. Methods By using Seldinger′s method, 40 cases of tubule pregnancy received superselective angiography of uterine artery,followed by perfusion of methotrexate (MTX) through the catheter and embolization of uterine artery with gelatin sponge. The concentration of serum ? HCG, the change of pelvic cavity, and the open condition of oviduct were regularly monitored postoperatively. Results Angiographic findings of tubule pregnancy were classified into 3 types. Type Ⅰ, no abnormal vascular appearance were found in 3 cases (7.5%). Type Ⅱ, patchy vascular staining of villi in parauterine area was observed in 4 cases (10.0%). Type Ⅲ, a round vascular staining of villi surrounded by small blood vessels in parauterine area occurred in 33 cases (82.5%). The cure rate in total 40 cases achieved 97.5% (39/40). After treatment, the mean time that the serum ? HCG concentration returned to normal was (7.66?2.01) d and the mean time that the menstruation returned to normal was (29.78?7.14) d. In 21 cases who hoped their fertility remaining intact, the oviduct were verified open by hysterosalpingography (HSG) in 20 cases, the open rate was 95.24%. Conclusion The treatment of tubule pregnancy by interventional technique was proved no harmful effect to reproductive organs and would expect to preserve fertility. This method could resolve the difficult problem of celiac hemorrhage which making conservative treatment impossible and internal hemorrhage happened in the course of traditional conservative therapy leading to treatment failure finally. This method might be a new conception and a choice to treat tubal pregnancy through artery.
