Published online Feb 6, 2023. doi: 10.12998/wjcc.v11.i4.788
Peer-review started: November 18, 2022
First decision: December 13, 2022
Revised: December 27, 2022
Accepted: January 12, 2023
Article in press: January 12, 2023
Published online: February 6, 2023
Processing time: 79 Days and 17.6 Hours
Ectopic pregnancy at cervical pregnancy, caesarean scar pregnancy, and interstitial pregnancy are rare; therefore, it is challenging to say that a standard treatment has been established.
Removal of ectopic pregnancies using methotrexate therapy and/or uterine artery embolization has been reported. However, delayed resumption of infertility treatments after methotrexate therapy is indicated, and negative effects on the next pregnancy after uterine artery embolization have been reported. To avoid these problems, we will establish a new treatment method for Cervical pregnancies, interstitial tubal pregnancies, and cesarean scar pregnancies, which are ectopic pregnancies with intrauterine implantation sites.
The purpose of this study was to examine the efficacy and safety of ultrasound-guided topical injection of absolute ethanol in ectopic pregnancies with an implantation site within the uterus.
We retrospectively examined the medical records of 21 patients who were diagnosed with an ectopic pregnancy with an intrauterine implantation site at our hospital, between April 2010 and December 2018, and underwent transvaginal ultrasound-guided local injections of absolute ethanol to determine the treatment outcomes. We evaluated the treatment methods, treatment outcomes, presence of bleeding requiring hemostasis measures and blood transfusion, complications, and treatment periods.
All patients completed treatment with transvaginal ultrasound-guided local injections of absolute ethanol. No massive hemorrhaging or serious adverse reactions were observed during treatment.
Transvaginal ultrasound-guided local injections of absolute ethanol could become a new option for intrauterine ectopic pregnancies when fertility preservation is desired.
Ectopic pregnancy at cervical pregnancy, caesarean scar pregnancy, and interstitial pregnancy are rare; therefore, it is challenging to say that a standard treatment has been established. Transvaginal ultrasound-guided local injections of absolute ethanol for ectopic pregnancies such as cervical pregnancies, interstitial tubal pregnancies, and cesarean scar pregnancies can preserve the uterus without serious adverse reactions. This treatment avoids the complications caused by methotrexate therapy and uterine artery embolization. This treatment may become a new treatment option for intrauterine ectopic pregnancy when fertility preservation is desired.