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Federación Mexicana de Ginecología y Obstetricia, A.C.

2012, Número 08

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Ginecol Obstet Mex 2012; 80 (08)


Tratamiento conservador de la gestación ectópica cervical

Bretón P, Garcés M, Orós D, González AR, Romero MÁ, Fabre E

Idioma: Español
Referencias bibliográficas: 35
Paginas: 514-520
Archivo PDF: 110.21 Kb.


RESUMEN

Antecedentes: el embarazo ectópico cervical es una forma rara de gestación ectópica (menos de 1% de todas las gestaciones ectópicas).
Objetivo: valorar la eficacia de las alternativas terapéuticas indicadas a pacientes con gestación ectópica cervical.
Material y método: análisis retrospectivo de todas las gestaciones ectópicas cervicales atendidas en nuestro servicio de enero 2005 a diciembre 2011.
Resultados: durante el periodo de estudio se diagnosticó gestación ectópica cervical a tres pacientes en nuestro servicio; es decir, una incidencia de 1.7 por cada 10,000 gestaciones. La presentación clínica fue hemorragia genital de intensidad moderada a severa. En dos casos se indicó tratamiento con metotrexato en dosis única de 50 mg/cm2, y en el tercero, legrado obstétrico y embolización de las arterias uterinas. Ninguno de los casos de este estudio requirió histerectomía posterior.
Conclusión: el tratamiento conservador de la gestación ectópica cervical es una alternativa terapéutica eficaz y con alto grado de seguridad.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Sowter MC, Farquhar CM. Ectopic pregnancy: an update. Current Opinion Obstet Gynecol 2004;16:289-93.

  2. Verena TV, Fly CA. Ectopic pregnancy. eMedicine. Disponible en: http://WWIN.emedicine.com/EMERG/topic478.htm.

  3. Condous G. Themanagement of early pregnancy complications. Best Pract Res Clin Obstet Gynaecol 2004;18:37-57.

  4. Celik C, Bala A, Acar A, Gezgine K, Akyurek C. Methotrexate for cervical pregnancy. A case report. J Reprod Med 2003;48:130-132.

  5. Rubin IC. Cervical pregnancy. Surg Gynecol Obstet 1911;13:625-633.

  6. Shinagawa S, Nagayama M. Cervical pregnancy as a possible sequela of induced abortion. Am J Obstet Gynecol 1969;105:282-284.

  7. Dicker D, Feldberg D, Samuel N, et al. (1985) Etiology of cervical pregnancy: association with abortion, pelvic pathology, IUDs, and Asherman’s syndrome. J. Reprod Med;30:25-27.

  8. Ginsburg ES, Frates MC, Rein MS, et al. Early diagnosis and treatment of cervical pregnancy in an in vitro fertilization program. Fertil Steril 1994;61:966-969.

  9. Weyerman PC, Verhoeven ATM, Alberda AT. Cervical pregnancy after in vitro fertilization and embryo transfer. Obstet Gynecol 1989;161:1145-1146.

  10. Shlomo Mashiach, Dahlia Admon, Gabriel Oelsner, Baram Paz, R Achiron. Cervical Shirodkar cerclage may be the treatment modality of choice for cervical pregnancy. Hum Reprod 2002;17(2):493-496.

  11. Kirk E, Condous G, Haider Z, Syed A, Ojha K, Bourne T. The conservative management of cervical ectopic pregnancies. Ultrasound Obstet Gynecol 2006;27:430-437.

  12. Wang Y, Xu B, Dai S, Zhang Y, Duan Y, Sun C. An efficient conservative treatment modality for cervical pregnancy: angiographic uterine artery embolization followed by immediate curettage. Am J Obstet Gynecol 2011;204(1):31.e1-7.

  13. Tang PP, Liu XY, Chen N, Dai Q, Cui QC, Jin ZY, Lang JH. Diagnosis and treatment of cervical ectopic pregnancy. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2010;32(5):497-500.

  14. Xiaolin Z, Ling L, Chengxin Y, Yiqing T, Jun W, Yan C, Guangxi T. Transcatheter intraarterial methotrexate infusion combined with selective uterine artery embolization as a treatment option for cervical pregnancy. J Vasc lnterv Radiol 2010 Jun;21(6):836-41. Epub 2010Apr18.

  15. Taylor JE, Yalcinkaya TM, Akar ME. Successful conservative management of cervical ectopic pregnancy: a case series. Arch Gynecol Obstet 2010;283(6):1215-1217. Epub 2010 May 29.

  16. Postawski K, Romanek K, Wróbel A, Rechberger T. Conservative treatment of cervical pregnancy in women: a review of the literature with case report Ginekol Poi 2009;80(9):704-707.

  17. Chelli O, Oimassi K, Bouaziz M, Manai S, Béchir Z, Sfar E, Chelli H. Early diagnosis and management of cervical ectopic pregnancy. Tunis Med 2009;87(9):616-620.

  18. Hirakawa M, Tajima T, Yoshimitsu K, lrie H, lshigami K, Yahata H, Wake N, Honda H. Uterine artery embolization along with the administration of methotrexate for cervical ectopic pregnancy: technical and clinical outcomes. AJR Am J Roentgenol 2009;192(6):1601-1607.

  19. Kim MG, Shim JY, Won HS, Lee PR, Kim A. Conservative management of spontaneous heterotopic cervical pregnancy using an aspiration cannula and pediatric Foley catheter. Ultrasound Obstet Gynecol 2009;33(6):733-734

  20. Yu B, Oouglas NC, Guarnaccia MM, Sauer MV. Uterine artery embolization as an adjunctive measure to decrease blood loss prior to evacuating a cervical pregnancy. Arch Gynecol Obstet 2009;279(5):721-724. Epub 2008 Sep 13.

  21. Shah AA, Grotegut CA, Likes CE 3rd, Miller MJ, Walmer OK. Heterotopic cervical pregnancy treated with transvaginal ultrasound-guided aspiration resulting in cervical site varices within the myometrium. Fertil Steril 2009;91(3):934.e19-22. Epub 2008 Nov 20.

  22. Verma U, Goharkhay N. Conservative management of cervical ectopic pregnancy. Fertil Steril 2009;91(3):671-674. Epub 2008 Mar 12.

  23. Kim JS, Nam KH, Kim TH, Lee HH, Lee KH. Hysteroscopic management of cervical pregnancy with intrauterine irrigation with H202. J Minim lnvasive Gynecol 2008;15(5):627-630. Epub 2008 Jul26.

  24. Oavis LB, Lathi RB, Milki AA, Oahan MH. Transvaginal ligation of the cervical branches of the uterine artery and injection of vasopressin in a cervical pregnancy as an initial step to controlling hemorrhage: a case report.J Reprod Med 2008;53(5):365-368.

  25. Nakao Y, Yokoyama M, lwasaka T. Uterine artery embolization followed by dilation and curettage for cervical pregnancy. Obstet Gynecol 2008 Feb;111(2Pt2):505-7.

  26. Corticelli A, Grimaldi M, Caporale E. Conservative management of cervical ectopic pregnancy: case report and review of literature. Ciin Exp Obstet Gynecol 2008;35(4):297-298.

  27. Tinelli A, Malvasi A, Vergara O, Casciaro S. Emergency surgical procedure for failed methotrexate treatment of cervical pregnancy: a case report. Eur J Contracept Reprod Health Care. 2007 Oec;12(4):391-395.

  28. Yang JH, Shih JC, Liu KL, Yang YS. Combined treatment with temporary intraoperative balloon occlusion of common iliac arteries and hysteroscopic endocervical resection with postoperative cervical balloon for intractable cervical pregnancy in an infertile woman. Fertil Steril 2007;88(5):1438.e11-3. Epub 2007 Jul 31.

  29. Martinelli P, Maruotti GM, Oppedisano R, Agangi A, Mazzarelli LL, Votino C, Quarantelli M, laccarino V. ls uterine artery embolization for cervical ectopic pregnancy always safe? J Minim lnvasive Gynecol 2007;14(6):758-763.

  30. Emmi AM, Oevoe LO, Chudgar OB, Holsten E, Layman LC. Successful management of cervical pregnancy with medical intervention only: a case report. J Reprod Med 2007;52(10):950-952.

  31. Xu B, Wang YK, Zhang YH, Wang S, Yang L, Oai SZ. Angiographic uterine artery embolization followed by immediate curettage: an efficient treatment for controlling heavy bleeding and avoiding recurrent bleeding in cervical pregnancy. J Obstet Gynaecol Res 2007;33(2):190-194.

  32. Verma U, Maggiorotto F. Conservative management of secondtrimester cervical ectopic pregnancy with placenta percreta. Fertil Steril 2007;87(3):697.e13-6. Epub 2006 Nov 29.

  33. Kirk E, Condous G, Haider Z, Syed A, Ojha K, Bourne T. The conservative management of cervical ectopic pregnancies. Ultrasound Obstet Gynecol 2006;27:430-437.

  34. Mesogitis S, Pilalis A, Oaskalakis G, Papantoniou N, Antsaklis A. Management of early viable cervical pregnancy. BJOG 2005;112(4):409-411.

  35. Hassiakos O, Bakas P, Creatsas G. Cervical pregnancy treated with transvaginal ultrasound-guided intra-amniotic instillation of methotrexate. Arch Gynecol Obstet 2005;271(1):69-72.




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