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1.
OBJECTIVE: To present a case of cervical ectopic pregnancy successfully treated with ultrasound-guided aspiration and single-dose methotrexate administered systemically. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 27-year-old nulliparous woman with a cervical ectopic pregnancy. INTERVENTION(S): Transvaginal ultrasound-guided aspiration of the cervical ectopic pregnancy followed by single-dose methotrexate administered systemically. MAIN OUTCOME MEASURE(S): Recovery of the patient, successful conservative treatment of the cervical ectopic pregnancy, with preservation of the uterus. RESULT(S): The cervical ectopic pregnancy was successfully aborted, and the reproductive capability of the patient was preserved. CONCLUSION(S): Transvaginal ultrasound-guided aspiration in combination with single-dose methotrexate administered systemically can be safely used to treat cervical ectopic pregnancies. 相似文献
2.
Objectives To report a case of tubal heterotopic pregnancy (HP) treated conservatively with transvaginal ultrasound-guided aspiration
and instillation of hyperosmolar glucose.
Methods Aspiration of the tubal ectopic pregnancy and hyperosmolar glucose instillation was performed with a 16-gauge needle under
transvaginal ultrasound guidance.
Results Unruptured tubal HP with positive cardiac activity was treated successfully without any further interventions, and intrauterine
pregnancy has reached full-term without any complications.
Conclusions Early diagnosis of this life-threatening condition is the key to its successful treatment. Transvaginal ultrasound-guided
aspiration and hyperosmolar glucose injection can be safely performed for the treatment of unruptured tubal HP. 相似文献
3.
《Reproductive biomedicine online》2008,16(6):803-805
An unusual case of a heterotopic cervico-isthmic pregnancy after IVF treatment occurred in a 34-year-old woman. Transvaginal ultrasound-guided aspiration of the gestational sac for embryo reduction was safely used to manage the pregnancy and preserve the intrauterine fetus. 相似文献
4.
目的:探讨宫颈妊娠的病因、诊断及保守性治疗方法。方法:回顾分析我院1996年1月1日至2010年12月31日收治的宫颈妊娠及体外授精胚胎移植术后宫内孕合并宫颈妊娠患者36例,探讨宫颈妊娠保守治疗方式的选择,并随访患者术后情况。结果:29例单纯宫颈妊娠:6例外院误诊为"难免流产",误诊率20.69%;10例经阴道B超引导下宫颈妊娠囊局部穿刺+MTX注射治疗,6例行子宫动脉栓塞术,6例MTX肌内注射治疗,7例腰麻下宫腔镜检查宫颈妊娠清除手术。7例宫内孕合并宫颈妊娠:1例阴道B超引导下局部妊娠囊穿刺注入KCl 1ml,3例期待疗法后清除宫颈妊娠物,3例腹部B超引导下宫颈妊娠物清除术。结论:阴道彩超用于宫颈妊娠的早期诊断有较大的价值,术前应充分评估,制定个体化的治疗方案。宫内孕合并宫颈妊娠的患者在腹部B超监测下清除宫颈妊娠物是有效的治疗方式之一,但要及时手术并且加强抗感染治疗。 相似文献
5.
6.
We present a case of heterotopic cervical pregnancy where intrauterine gestation was preserved successfully. A 40-year-old Japanese woman presented with heterotopic cervical pregnancy after intracytoplasmic sperm injection with elongated spermatid. An ultrasound examination showed heterotopic cervical pregnancy. Intrauterine gestation was preserved successfully with the use of local vasopressin injection, followed by curettage of cervical implantation and local methotrexate injection. The cervical pregnancy resolved, and a healthy full-term infant was delivered. When early diagnosis of a heterotropic cervical pregnancy is made, selective reduction of a cervical implantation might allow preservation of the intrauterine gestation, without hysterectomy. (Reprod Med Biol 2005; 4 : 221–223) 相似文献
7.
Maternal complication of cervical heterotopic pregnancy after successful potassium chloride fetal reduction 总被引:3,自引:0,他引:3
OBJECTIVE: To present a case of maternal morbidity encountered in a cervical heterotopic pregnancy after successful potassium chloride (KCl) injection for transvaginal multifetal pregnancy reduction. DESIGN: Case report. SETTING: Tertiary referral care center. PATIENT(S): A woman with heterotopic twin gestation after IVF. INTERVENTION(S): Diagnosis of a viable cervical heterotopic pregnancy was made at 6 weeks by ultrasound. A transvaginal reduction by KCl injection of the cervical pregnancy was performed under sonographic guidance. MAIN OUTCOME MEASURE(S): Maternal morbidity and mortality. RESULT(S): Although contents of the gestational sac within the cervix resolved, the trophoblastic tissue increased in both size and vascularity. The patient continued to have self-limited vaginal bleeding throughout the pregnancy. However, at 31 weeks, she had an acute hemorrhage, resulting in an emergency cesarean hysterectomy secondary to profuse bleeding from retained cervical trophoblastic tissue. CONCLUSION(S): Although KCl transvaginal multifetal pregnancy reduction might successfully terminate a cervical heterotopic pregnancy, the ongoing pregnancy might be complicated by persistence and even enlargement of remaining trophoblastic tissue, leading to obstetric hemorrhage. 相似文献
8.
Heterotopic pregnancy, or simultaneous intrauterine and extrauterine gestation, is a relatively rare condition. However, induced ovulation and assisted reproductive technologies have markedly increased the incidence of this condition. In this article, a case of heterotopic pregnancy after in vitro fertilization and embryo transfer is presented in which the viable cervical pregnancy was treated by transvaginal ultrasound-guided puncture and injection of potassium chloride in conjunction with methotrexate at week 6 of gestation. At week 12 of gestation, the intrauterine gestation was viable and complete resorption of the cervical pregnancy had occurred. At week 30 of gestation, a healthy baby was delivered by Caesarian section after prelabour rupture of membranes. 相似文献
9.
Majedah Al-Azemi William L. Ledger Gillian M. Lockwood David H. Barlow 《Human fertility (Cambridge, England)》2013,16(1):67-69
Heterotopic pregnancy, or simultaneous intrauterine and extrauterine gestation, is a relatively rare condition. However, induced ovulation and assisted reproductive technologies have markedly increased the incidence of this condition. In this article, a case of heterotopic pregnancy after in vitro fertilization and embryo transfer is presented in which the viable cervical pregnancy was treated by transvaginal ultrasound-guided puncture and injection of potassium chloride in conjunction with methotrexate at week 6 of gestation. At week 12 of gestation, the intrauterine gestation was viable and complete resorption of the cervical pregnancy had occurred. At week 30 of gestation, a healthy baby was delivered by Caesarian section after prelabour rupture of membranes. 相似文献
10.
Successful resection of a heterotopic cervical pregnancy resulting from intracytoplasmic sperm injection 总被引:7,自引:0,他引:7
OBJECTIVE: To report a case of cervical heterotopic pregnancy after IVF-ET treatment. DESIGN: Case report. SETTING: Private IVF center. PATIENT(S): A woman who had undergone controlled ovarian hyperstimulation and intracytoplasmic sperm injection-ET for primary male factor infertility. INTERVENTION(S): Resection of cervical heterotopic pregnancy by hysteroscopy. MAIN OUTCOME MEASURE(S): Successful treatment of heterotopic cervical pregnancy. RESULT(S): A successful pregnancy resulting in a term baby. CONCLUSION(S): Hysteroscopic resection can be used to treat a cervical heterotopic pregnancy. 相似文献
11.
Anteby EY Rahav G Hanoch J Shimonovitz S Yagel S Laufer N 《Infectious diseases in obstetrics and gynecology》1996,4(5):298-300
Background: Increasing reports of intrauterine device (IUD)-related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo-ovarian abscess is identified.Case: A 38-year-old woman suffering from Actinomyces pelvic abscess unresponsive to medical treatment underwent transvaginal ultrasound-guided needle aspiration. It resulted in marked improvement and avoided surgical treatment.Conclusion: Transvaginal needle aspiration of Actinomyces pelvic abscess may be an alternative to surgical therapy, thereby allowing the preservation of pelvic organs. 相似文献
12.
《Gynecological endocrinology》2013,29(12):1007-1009
Introduction.?Cervical twin ectopic pregnancy after IVF-ET is rare and catastrophic complication. However, here is no consensus on the best treatment strategy.Patient and method.?Case report of cervical twin ectopic pregnancy after IVF-ET treated by transvaginal ultrasound guided aspiration plus systemic single injection of methotrexate, which followed by full-term delivery in next IVF-ET cycle.Conclusion.?Transvaginal ultrasound-guided aspiration and systemic methotrexate administration can be safely and easily used to treat cervical ectopic pregnancies and to preserve the fertility of the patient without any major complications. 相似文献
13.
《Journal of minimally invasive gynecology》2020,27(4):977-980
Heterotopic pregnancy refers to the simultaneous presence of ectopic pregnancy and intrauterine pregnancy. With the advent of assisted reproductive technology, the overall incidence of heterotopic pregnancies has risen. We report a case of a 36-year-old woman with type 2 diabetes mellitus and 1-year of primary infertility. Following oral ovulation induction cycles and intrauterine insemination, diagnosis of heterotopic cervical pregnancy was made by ultrasonography at 7.4 weeks of gestation. Laser ablation of the cervical pregnancy was performed achieving adequate homeostasis at the implantation site and preserving the intrauterine pregnancy. A healthy infant was delivered at 36 0/7 weeks by cesarean section.Laser ablation is a minimally invasive procedure that appears to lead to successful outcomes in the treatment of heterotopic cervical pregnancy. 相似文献
14.
Electrodessication of a cervical heterotopic pregnancy 总被引:2,自引:0,他引:2
A cervical heterotopic assisted reproductive technology (ART) pregnancy was diagnosed sonographically. The cervical pregnancy was electrodesiccated with a Kleppinger device. The intrauterine pregnancy was carried to term. 相似文献
15.
Christian De Geyter Maria De Geyter Eberhard Nieschlag 《Journal of assisted reproduction and genetics》1998,15(3):111-116
Purpose:
Our purpose was to demonstrate the feasibility of the routine aspiration of supernumerary follicles in infertile patients with imminent polyovulation after ovulation induction with gonadotropins and to examine its effect on the frequency of cycle cancellation and on the (multiple) pregnancy rate.
Methods:
The data on 796 treatment cycles, performed between 1989 and 1996 on 410 infertile couples, were analyzed retrospectively. From October 1992, whenever necessary, supernumerary ovarian follicles were selectively aspirated transvaginally under ultrasound guidance to prevent the ovulation of more than three follicles. Thereafter, intrauterine insemination was performed.
Results:
After the adoption of transvaginal ultrasound-guided aspiration of supernumerary follicles into the treatment protocol in October 1992, the number of canceled cycles (P < 0.0001) and the multiple pregnancy rate (P < 0.01) were significantly reduced compared to those previously. The overall pregnancy rate remained stable. No ovarian hyperstimulation syndrome requiring hospitalization was noted, and no complications resulting from the follicle aspiration were registered.
Conclusions:
Transvaginal ultrasound-guided aspiration of supernumerary ovarian follicles increases both the efficacy and the safety of ovulation induction with gonadotropins. Because of the limited equipment required, this method represents an alternative for conversion of overstimulated cycles to more costly alternatives such as in vitro fertilization. 相似文献
16.
Transvaginal embryo aspiration--a safe method for selective reduction in multiple pregnancies. 总被引:4,自引:0,他引:4
J Itskovitz-Eldor A Drugan J Levron I Thaler J M Brandes 《Fertility and sterility》1992,58(2):351-355
OBJECTIVE: To evaluate pregnancy outcome after transvaginal selective embryo aspiration and to compare the results with those reported previously with other techniques for selective abortion. DESIGN: Retrospective case series. SETTING: University-based in vitro fertilization (IVF) program. PATIENTS: Nineteen women with multiple pregnancy who conceived after ovulation induction or IVF/gamete intrafallopian transfer. INTERVENTION: Transvaginal ultrasound-guided aspiration of the embryo(s) was performed at 7 to 8 weeks of gestation. MAIN OUTCOME MEASURES: Early and late complications related to the procedure, outcome of pregnancy, and birth weight. RESULTS: In 18 cases, the initial number of embryos (3 to 7) was reduced to two. In 1 case, the number of embryos was reduced from 4 to 3. None of the remaining fetuses vanished after the procedure. One patient delivered at 25 weeks and all other patients delivered healthy, viable infants (a pregnancy loss rate of 5.3%). CONCLUSIONS: Transvaginal embryo aspiration in early gestation appears to be a simple and relatively safe procedure for selective termination in patients with high-order multiple pregnancy. The cumulative loss rate of selective termination procedures previously reported by others is three times higher than the loss encountered in our series. This earlier procedure may be more acceptable to patients from emotional and religious points of view. 相似文献
17.
BACKGROUND: The etiology of cervical heterotopic pregnancy is unknown, but most are associated with assisted reproductive techniques. Various types of conservative management to save the intrauterine pregnancy have been attempted. CASE: A 35-year-old woman conceived after in vitro fertilization/embryo transfer for primary malefactor infertility. At 7(3/7) weeks of gestation, only the embryo was aspirated without fluid. Delivery of a healthy infant at 35 weeks was successful. CONCLUSION: Simple embryo aspiration under transvaginal ultrasonography guidance can be used in cervical heterotopic pregnancy. 相似文献
18.
Transvaginal ultrasound-guided embryo transfer improves outcome in patients with previous failed in vitro fertilization cycles 总被引:5,自引:0,他引:5
OBJECTIVE: To determine the effect of transvaginal ultrasound-guided ET in IVF cycles performed on patients who had previously failed to conceive from IVF and compare the results to previous cycles where ultrasound guidance was not used. DESIGN: Retrospective clinical study.Setting: Private practice IVF program. PATIENT(S): One hundred twenty-nine women undergoing consecutive cycles of IVF where fresh embryos were transferred. INTERVENTION(S): Transvaginal ultrasound guidance was used during transfer of embryos. MAIN OUTCOME MEASURE(s): Patient age, number of ampules of gonadotropin used, maximum E(2) level, number of oocytes retrieved, number of two pronuclei embryos obtained, number of embryos transferred, mean embryo score, implantation and pregnancy rate. RESULT(S): There was no difference in any of the clinical parameters measured in IVF cycles resulting in pregnancy when transvaginal ultrasound-guided ET was used compared to the failed cycles when there was no ultrasound guidance. Of the patients who previously had failed IVF cycles and subsequently had IVF cycles with ultrasound guidance, those who became pregnant had higher mean embryo scores than those who did not become pregnant. Overall implantation and pregnancy rates were higher during the study period when transvaginal ultrasound guidance was used than in the previous 3 years when it was not used. CONCLUSION(S): Transvaginal ultrasound-guided ET may be responsible for successful IVF cycles in patients who had previously failed to conceive when embryos were transferred by the clinical touch method. Transvaginal ultrasound guidance may also be responsible for an overall increase in embryo implantation and pregnancy compared to the use of the clinical touch method. 相似文献
19.
Conservative treatment by angiographic artery embolization of an 11-week cervical pregnancy after a period of heavy bleeding 总被引:4,自引:0,他引:4
Suzumori N Katano K Sato T Okada J Nakanishi T Muto D Suzuki Y Ikuta K Suzumori K 《Fertility and sterility》2003,80(3):617-619
OBJECTIVE: To describe a rare case of conservative treatment of an 11-week cervical pregnancy after a period of heavy bleeding. DESIGN: Case report. SETTING: A university hospital. PATIENT(S): A 33-year-old woman was admitted to our hospital for treatment of a cervical pregnancy. Two-and-a-half years thereafter, she gave birth to a healthy baby by vaginal delivery at 38 weeks of gestation. INTERVENTION(S): Systemic methotrexate treatment, ligation of descending branches of uterine arteries, cervical cerclage, and unilateral internal iliac artery embolization. MAIN OUTCOME MEASURE(S): Transvaginal ultrasound, magnetic resonance imaging, and arteriography findings. RESULT(S): The patient was successfully treated with unilateral internal iliac artery embolization on the same side as the pregnancy in the 11th gestational week. CONCLUSION(S): After failed methotrexate and vessel ligation in cervical pregnancy, unilateral internal iliac artery embolization is an effective and conservative treatment that allows preservation of reproduction potential. 相似文献
20.
《The journal of maternal-fetal & neonatal medicine》2013,26(13):1378-1381
AbstractObjective: To evaluate the efficacy of conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided local injection.Methods: Retrospective case series at University tertiary care Hospital. Eight patients diagnosed with cervical pregnancy with embryonic heart activity managed conservatively. The intervention was ultrasound-guided local injection of methotrexate (1?mg/kg) and potassium chloride (2?meq/mL). Measurements were occurrence of morbidity, necessity for further intervention, the initial titers of beta-hCG, interval of time in which the levels of beta-hCG became negative, period for regression of cervical pregnancy at ultrasound and future pregnancy.Results: All patients were treated successfully. The initial levels of beta-hCG ranged from 3013 to 71199 mUI/mL. One case evaluated with infection. There was no need for additional intervention in our series study. The interval of time for the levels of beta-hCG becomes negative range from 2 to 12 weeks. The period for the regression of the cervical pregnancy at ultrasound range from 3 to 14 weeks. In two cases intrauterine pregnancies occurred after the treatment.Conclusion: Conservative management of cervical pregnancy with embryonic heart activity by ultrasound-guided injection is an effective treatment avoiding the need of further intervention. 相似文献