Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy
BackgroundCervical pregnancy (CP) is an uncommon type of ectopic pregnancy with a rising risk to life. Currently, there is no universal protocol for the safe and effective management of CP. This study aimed to investigate the clinical efficacy of high-intensity focused ultrasound ablation (HIFU) vs....
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.990066/full |
| _version_ | 1811261470884757504 |
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| author | Waixing Li Xiaoli Gan Nidhi Kashyap Lingxiao Zou Aiqian Zhang Dabao Xu |
| author_facet | Waixing Li Xiaoli Gan Nidhi Kashyap Lingxiao Zou Aiqian Zhang Dabao Xu |
| author_sort | Waixing Li |
| collection | DOAJ |
| description | BackgroundCervical pregnancy (CP) is an uncommon type of ectopic pregnancy with a rising risk to life. Currently, there is no universal protocol for the safe and effective management of CP. This study aimed to investigate the clinical efficacy of high-intensity focused ultrasound ablation (HIFU) vs. uterine artery embolization (UAE) in the management of CP to develop a standard for the treatment of CP.MethodsFrom January 2015 to October 2021, 36 patients with CP were diagnosed, treated, and followed up at the Department of Gynecology of Third Xiangya Hospital of Central South University. A total of 11 patients were treated with HIFU followed by suction curettage under hysteroscopic guidance, and 25 patients were treated with UAE followed by suction curettage under hysteroscopic guidance. Medical records and pregnancy outcomes were retrospectively analyzed.ResultsCompared to the UAE group, the HIFU group had a shorter interval time (1.5 ± 0.21 days vs. 2.6 ± 0.26 days), shorter duration of hospitalization (5.5 ± 0.31 days vs. 6.6 ± 0.21 days), shorter recovery time of menstruation (30.6 ± 7.09 days vs. 36.9 ± 5.54 days), fewer adverse reactions (0/11 vs. 9/25), and fewer postoperative complications (1/11 vs. 8/25). There were no significant differences in age, gravidity, parity, abortion, gestational age, cardiac pulsation, admission symptoms, hemoglobin level, largest diameter of the sac/mass, serum human chorionic gonadotropin (hCG) level at admission, hospitalization expenses, hospitalization days, blood loss during curettage, degree of hCG decline, residue after curettage, fertility requirement, and pregnancy outcomes.ConclusionBoth HIFU and UAE are safe and effective in the treatment of patients with CP. Compared to UAE, HIFU treatment for CP is a safer and more effective therapeutic schedule owing to the advantages of being more minimally invasive, shorter interval time, shorter hospitalization days and recovery time of menstruation, fewer adverse reactions, and fewer postoperative complications. |
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| format | Article |
| id | doaj.art-13605505f9014cbcb9815eb33371bc09 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T19:05:04Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-13605505f9014cbcb9815eb33371bc092022-12-22T03:20:02ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-09-01910.3389/fmed.2022.990066990066Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancyWaixing Li0Xiaoli Gan1Nidhi Kashyap2Lingxiao Zou3Aiqian Zhang4Dabao Xu5Department of Obstetrics and Gynecology, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Obstetrics and Gynecology, Pingxiang Maternal and Child Health Care Hospital, Pingxiang, ChinaDepartment of Obstetrics and Gynecology, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Obstetrics and Gynecology, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Obstetrics and Gynecology, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Obstetrics and Gynecology, The Third Xiangya Hospital, Central South University, Changsha, ChinaBackgroundCervical pregnancy (CP) is an uncommon type of ectopic pregnancy with a rising risk to life. Currently, there is no universal protocol for the safe and effective management of CP. This study aimed to investigate the clinical efficacy of high-intensity focused ultrasound ablation (HIFU) vs. uterine artery embolization (UAE) in the management of CP to develop a standard for the treatment of CP.MethodsFrom January 2015 to October 2021, 36 patients with CP were diagnosed, treated, and followed up at the Department of Gynecology of Third Xiangya Hospital of Central South University. A total of 11 patients were treated with HIFU followed by suction curettage under hysteroscopic guidance, and 25 patients were treated with UAE followed by suction curettage under hysteroscopic guidance. Medical records and pregnancy outcomes were retrospectively analyzed.ResultsCompared to the UAE group, the HIFU group had a shorter interval time (1.5 ± 0.21 days vs. 2.6 ± 0.26 days), shorter duration of hospitalization (5.5 ± 0.31 days vs. 6.6 ± 0.21 days), shorter recovery time of menstruation (30.6 ± 7.09 days vs. 36.9 ± 5.54 days), fewer adverse reactions (0/11 vs. 9/25), and fewer postoperative complications (1/11 vs. 8/25). There were no significant differences in age, gravidity, parity, abortion, gestational age, cardiac pulsation, admission symptoms, hemoglobin level, largest diameter of the sac/mass, serum human chorionic gonadotropin (hCG) level at admission, hospitalization expenses, hospitalization days, blood loss during curettage, degree of hCG decline, residue after curettage, fertility requirement, and pregnancy outcomes.ConclusionBoth HIFU and UAE are safe and effective in the treatment of patients with CP. Compared to UAE, HIFU treatment for CP is a safer and more effective therapeutic schedule owing to the advantages of being more minimally invasive, shorter interval time, shorter hospitalization days and recovery time of menstruation, fewer adverse reactions, and fewer postoperative complications.https://www.frontiersin.org/articles/10.3389/fmed.2022.990066/fullhigh-intensity focused ultrasound ablation (HIFU)uterine artery embolization (UAE)cervical pregnancy (CP)hysteroscopic curettageclinical curative effect |
| spellingShingle | Waixing Li Xiaoli Gan Nidhi Kashyap Lingxiao Zou Aiqian Zhang Dabao Xu Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy Frontiers in Medicine high-intensity focused ultrasound ablation (HIFU) uterine artery embolization (UAE) cervical pregnancy (CP) hysteroscopic curettage clinical curative effect |
| title | Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy |
| title_full | Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy |
| title_fullStr | Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy |
| title_full_unstemmed | Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy |
| title_short | Comparison of high-intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy |
| title_sort | comparison of high intensity focused ultrasound ablation and uterine artery embolization in the management of cervical pregnancy |
| topic | high-intensity focused ultrasound ablation (HIFU) uterine artery embolization (UAE) cervical pregnancy (CP) hysteroscopic curettage clinical curative effect |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.990066/full |
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