Uterine artery embolization with methotrexate infusion as treatment for cesarean scar pregnancy. Case report

Uterine artery embolization with methotrexate infusion as treatment for cesarean scar pregnancy. Case report

Author Elito Junior, Julio Autor UNIFESP Google Scholar
Araujo Junior, Edward Autor UNIFESP Google Scholar
Martins Santana, Eduardo Felix Autor UNIFESP Google Scholar
Szejnfeld, Denis Autor UNIFESP Google Scholar
Helfer, Talita Micheletti Autor UNIFESP Google Scholar
Nardozza, Luciano Marcondes Machado Autor UNIFESP Google Scholar
Moron, Antonio Fernandes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Cesarean scar pregnancy is a rare form of ectopic pregnancy. It is associated with many complications, including a high risk of massive bleeding and hysterectomy under unfavorable conditions. Conservative treatment with systemic methotrexate (MTX) has been used preferentially with the aim of allowing the patient to have a reproductive future. However, cases of complex ectopic masses in a cesarean scar with guarded prognosis demand techniques that are more effective, such as uterine artery embolization (UAE) in association with intra-arterial MTX infusion. We describe the case of a 35-year-old patient in the 8th week of pregnancy who was referred to us because of genital bleeding and suspected ectopic pregnancy in the cesarean scar. After confirmation of the diagnosis, an initial attempt at systemic treatment with MTX was made. This was abandoned due to the elevation of the hepatic transaminase level. In addition, because of the complexity of the mass and the patient's desire to preserve her reproductive capacity, it was decided to perform UAE with local MTX infusion. The procedure was performed successfully and the patient's fertility was preserved.
Keywords cesarean scar pregnancy
ultrasound
magnetic resonance imaging
methotrexate
embolization
Language English
Date 2013-09-01
Published in Medical Ultrasonography. Cluj-napoca: Soc Romana Ultrasonografe Medicina Biologie-srumb, v. 15, n. 3, p. 240-243, 2013.
ISSN 1844-4172 (Sherpa/Romeo, impact factor)
Publisher Soc Romana Ultrasonografe Medicina Biologie-srumb
Extent 240-243
Origin http://dx.doi.org/10.11152/mu.2013.2066.153.jej1eaj2
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000334023600012
URI http://repositorio.unifesp.br/11600/44878

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