Hysteroscopic management of a heterotopic pregnancy following uterine artery embolization: a case report.
J Med Case Rep
; 10(1): 324, 2016 Nov 15.
Article
in En
| MEDLINE
| ID: mdl-27846865
ABSTRACT
BACKGROUND:
Intra-uterine pregnancy coexisting with cervical pregnancy (heterotopic pregnancy) is a rare condition and its management is challenging because of the massive bleeding associated with cervical pregnancy. Uterine artery embolization followed by hysteroscopic removal of cervical and intra-uterine products of conception can theoretically prevent massive bleeding and provide a direct view during the removal. Hysteroscopic management following uterine artery embolization of heterotopic pregnancy after in vitro fertilization and embryo transfer is rarely reported. CASE PRESENTATION A 33-year-old primigravida, Asian, married, nonsmoker, nonalcoholic woman presented with heavy vaginal bleeding 3 weeks after in vitro fertilization and embryo transfer with a documented history of two embryo implantations in her uterine cavity. Transvaginal ultrasonography revealed a gestational sac of 15 mm × 9 mm × 9 mm with cardiac activity, showing a 3.0-mm-diameter yolk sac in the uterine cavity and a 15 mm × 11 mm × 8 mm gestational sac with cardiac activity, showing a 2.9-mm-diameter yolk sac in the cervical canal. The bilateral uterine artery embolization followed by hysteroscopic removal of both the gestational products was successfully performed after our patient and her family chose to give up the intra-uterine pregnancy due to the risk of heavy bleeding associated with cervical pregnancy.CONCLUSIONS:
Uterine artery embolization followed by hysteroscopic removal of cervical and intra-uterine gestational products in the first trimester is safe and feasible, while preserving future fertility.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Uterine Hemorrhage
/
Fertilization in Vitro
/
Cervix Uteri
/
Embryo Transfer
/
Uterine Artery Embolization
/
Pregnancy, Heterotopic
Type of study:
Etiology_studies
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
J Med Case Rep
Year:
2016
Document type:
Article
Affiliation country:
China