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The Investigation of the Clinical Value of the Interventional Therapy of Cervical Pregnancy through Uterine Artery (Analysis of 12 Medical Cases of Illness)

Author: HanZuoJiang
Tutor: DengYanJie
School: Dalian Medical University
Course: Obstetrics and Gynaecology
Keywords: Cervical pregnancy Interventional treatment Uterine artery Methotrexate (MTX) Embolism
CLC: R714.22
Type: Master's thesis
Year: 2011
Downloads: 3
Quote: 0
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Abstract


Objective: Investigate the clinical curative effect and its advantages of the interventional therapy of cervical pregnancy through uterine artery.Methods: Selected the 12 patients of the interventional therapy of cervical pregnancy in Maternity Hospital of Dalian and Dalian Central Hospital from January 2008 to February 2010, and retrospectively analyzed diagnostic medical treatment and prognosis. 12 patients aged 23 to 38 years old, mean 26.5 years old. 12 patients of cervical pregnancy were impregnation many times, on average 2.4 times, 2 cases had histories of c-section; of which 10 cases had undergone induced abortion two times before this pregnancy. The 12 patients all had histories of menopause, ranging from 37 days to 49 days, on average 59.2 days. The 12 patients all had irregular vaginal bleeding, bleeding time ranged from 3 days to 20 days, an average of 12 days. 12 patients of cervical pregnancy were performed after admission in with bilateral uterine artery infusion of methotrexate and embolism. 2 cases of 12 patients before entering our hospital were misdiagnosed in early pregnancy by the other hospital, incomplete abortion and complete curettage of uterine cavity resulted in intraoperative bleeding and postoperative reduplicative bleeding, through the treatment of the routine transfusion, blood transfusion, stanching bleeding, gauze stuffing, no obviously improvement, then the patients who had been emergency admitted in our hospital were performed with bilateral uterine artery infusion and embolism; 10 patients were performed the bilateral uterine artery MTX infusion and embolism treatment before the operation. 12 patients were postmenopausal patients with cervical pregnancy history and the history of irregular vaginal bleeding. 12 patients admitted underwent serumβsubunit of human chorionic gonadotropin determination (bloodβ-HCG) and ultrasound examination, were diagnosed definitely, 12 patients were undergone bilateral uterine artery MTX, then used gelatin sponge particles embolizing to blood stagnation, and routinely given antibiotics and other symptomatic treatment. 10 cases of fetal material excreted by themselves were not special treatment, 2 patients who failed to discharge spontaneously were performed with complete curettage of uterine cavity after one week.Results: 12 cases of cervical pregnancy that underwent uterine artery embolism MTX infusion and embolism achieved a good therapeutic effect, By bilateral uterine artery MTX, then used gelatin sponge particles embolizing to blood stagnation, the success rate of bilateral uterine artery MTX infusion and embolism was 100% which achieved fully hemostasis effects and successfully retained the uterus. 10 cases of the patients with fetal material removed from the bodies themselves were not made special treatment, 2 patients who failed to discharge by themselves underwent complete curettage of uterine cavity together with bleeding on average 10ml after one week, the tissue of uterine curettage was sent for pathological examination, the result of which was villus and deciduum. The 12 patients reviewed serumβ-HCG and color Doppler ultrasound. The serumβ-HCG of 12 patients returned to normal 3 to 5 weeks later; 12 patients recovered menstrual cycle from 1 to 2 months later, review of ultrasound prompt resumption of normal cervix.Conclusion: The interventional therapy of cervical pregnancy through uterine artery can control effective and prevent shed blood, and shorten the treatment cycle. The interventional therapy of cervical pregnancy is a safe and effective, minimally invasive, curative effect exactly therapy, and which can retain breeding function, and is worth promotion.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Pathological pregnancy ( abnormal pregnancy ) > Ectopic pregnancy ( ectopic pregnancy )
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