Diagnostic multimodal imaging and therapeutic transcatheter arterial chemoembolization for conservative management of hemorrhagic cesarean scar pregnancy

European Journal of Obstetrics, Gynecology, and Reproductive Biology
Akihiro TakedaHiromi Nakamura

Abstract

To evaluate the value of emergency transcatheter arterial chemoembolization (TACE) for initial conservative management of hemorrhagic cesarean scar pregnancy after multimodal image diagnosis. Five consecutive cases of hemorrhagic cesarean scar pregnancy were diagnosed for precise localization of ectopic placentation site, depth of placental invasion and uteroplacental neovascularization by imaging studies including color Doppler ultrasonography, magnetic resonance imaging (MRI) and three-dimensional computerized tomographic angiography. Emergency TACE with dactinomycin was initially performed to achieve immediate hemostasis and cytotoxic effects on chorionic villous tissue. Then, the need for either expectant management or subsequent hysteroscopic resection was individually determined. Systemic methotrexate (MTX) administration was added when delayed decline of serum hCG value was noted. On MRI, total placental invasion to the serosa of the anterior uterine wall was diagnosed in three cases, while the two remaining cases showed subtotal invasion to the anterior uterine wall. All cases were managed by emergency TACE as an initial conservative measure. Subsequently, spontaneous expulsion of gestational products occurred in one ca...Continue Reading

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Citations

Nov 13, 2012·Archives of Gynecology and Obstetrics·Aiwen LeZhonghai Wang
Oct 21, 2011·Current Opinion in Obstetrics & Gynecology·Katarzyna Litwicka, Ermanno Greco
Mar 19, 2014·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Akihiro TakedaHiromi Nakamura
Jul 19, 2014·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Qiang HuangRen-You Zhai
Jul 25, 2014·The Journal of Obstetrics and Gynaecology Research·Qiang HuangRen-You Zhai
Jan 28, 2015·Journal of Minimally Invasive Gynecology·Akihiro TakedaHiromi Nakamura
Jul 17, 2015·The Journal of Obstetrics and Gynaecology Research·Akihiro TakedaHiromi Nakamura
Mar 17, 2015·Gynecological Surgery·Zhang HuanxiaoYao Shuzhong
Sep 17, 2016·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Yanli LiWeishun Lan
May 21, 2015·Einstein·Vinicius Adami Vayego FornazariSuzan Menasce Goldman
Nov 5, 2013·Current Opinion in Obstetrics & Gynecology·Katarzyna Litwicka, Ermanno Greco
Oct 6, 2017·Archives of Gynecology and Obstetrics·Akihiro Takeda, Wataru Koike

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