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OBJECTIVE:To investigate the effects of uterine arterial embolization combined with Methotrexate and Lactate ethacri-dine on related indexes of mid-pregnant patients with placenta previa abortion. METHODS:The data of 100 mid-pregnant patients with placenta previa who required inducing labor was retrospectively analyzed and divided into observation group(50 cases)and control group(50 cases)by different treatment. Control group received uterine arterial embolization before inducing labor,then received Lac-tate ethacridine injection 100 mg,amniotic injection+Mifepristone tablet 75 mg,and aborted after 2 d. Observation group received uterine arterial embolization after uterine arterial perfusionon both sides,then received Methotrexate for injection 50 mg/side after uter-ine arterial embolization catheter entering uterine artery,Lactate ethacridine injection(the same usage and dosage as control group)+Mifepristone tablet(the same usage and dosage as control group)was given after 12 h. Total parturition,intrapartum hemorrhage,hos-pitalization time,menstruation recovery time,cesarean section,hysterectomy,retained placenta and clearing palace in 2 groups were observed,and postoperative complications were recorded. RESULTS:Intrapartum hemorrhage,hospitalization time,cesarean section rate and hysterectomy rate in observation group were significantly lower than control group,with statistical significance(P0.05). There was no significant difference in the incidence of postoperative complications in 2 groups(P>0.05). CONCLUSIONS:Uterine arterial embolization combined with Methotrexate and Lactate ethacridine can effectively reduce the hemor-rhage of mid-pregnant patients with placenta previa abortion,shorten hospitalization time,and decrease cesarean section and hysterec-tomy rate.
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Objective To explore comparison between methotrexate and uterine arterial embolization in β-HCG, bleeding volume and success rate of women with cesarean scar pregnancy after cesarean section.Methods 42 patients who were diagnosed with cesarean scar pregnancy after cesarean section were collected.All patients were randomly divided into uterine arterial embolization group and methotrexate group,21 cases in each group corresponding treatment were given respectively, after the treatment, the serum levels of β-HCG, bleeding volume and success rate were detected in all patients.Results After treatment, compared with methotrexate group, the serum level ofβ-HCG was lower in the uterine arterial embolization group,and the difference was statistically significant(P<0.05); the bleeding volume was lower in the uterine arterial embolization group(P<0.05); the success rate was higher in the uterine arterial embolization group(P <0.05).Conclusion Compared with methotrexate,the uterine arterial embolization can significantly reduce the serum level ofβ-HCG in patients with cesarean scar pregnancy after cesarean section,reduce the amount of bleeding, improve the success rate of treatment.
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Uterine arterial pseudoaneurysm is a very rare condition usually associated with postpartum hemorrhage. It almost never occurs after cervical conization; however, since ruptured pseudoaneurysm could be life threatening, we should consider the possibility of vascular injury such as pseudoaneurysm when we find a patient with vaginal bleeding after the process of surgical operation. Emergency arterial embolization is a well established therapeutic option to control the ruptured pseudoaneurysm. This is a case report of uterine arterial pseudoaneurysm causing intra-abdominal bleeding followed by cervical conization, which was successfully treated by uterine artery embolization.
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Humans , Aneurysm, False , Conization , Emergencies , Hemorrhage , Postpartum Hemorrhage , Uterine Artery Embolization , Uterine Artery , Uterine Hemorrhage , Vascular System InjuriesABSTRACT
31 patients from Anhui province maternal and child health care with cesarean scar pregnancy ( CSP ) treated with UAE ( before or after uterine curettage) were analyzed retrospectively. 12 subjects with a definite diag-nosis of CSP were offered preventive UAE. 1 case of an emergency rupture of the CSP patient was offered emergen-cy interventional therapy. The other eight patients,who were misdiagnosed as having an intrauterine pregnancy,with the symptoms of active vaginal bleeding were treated with emergency UAE after uterine curettage. The results showed all the 31 patients with CSP were resolved successfully without hysterectomy and had a significant decrease on the data ofβ-HCG. 24 patients received preventive UAE combined with methotrexate followed by uterine curet-tage. 3 patients received a excision of the scar in the uterus after UAE. 4 patients had a UAE combined with conser-vative medication. Results showed that UAE might be an effective means of treating CSP, including treatment in an emergency setting. It decreases the incidence rate of hysterectomy.
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Objective To discuss the therapeutic effect of uterine arterial embolization in treating adenomyosis.Methods Uterine arterial embolization was performed in 80 patients with adenomyosis.The patients were followed up for 3,6,12 and 24 months after the operation.After the treatment the degree of dysmenorrhea,the menstrual flow and the uterine volume were observed and were compared with those before the treatment.Results After uterine arterial embolization the clinical symptoms were relieved in all 80 patients.The menstrual flow was markedly decreased,the anemia was obviously improved and the uterine volume was significantly reduced,while the ovary functioning was not apparently affected.The symptom of dysmenorrhea completely disappeared one month after the therapy in 76 cases and four months after the therapy in the remaining 4 cases.Conclusion Uterine arterial embolization is a mini-invasive and safe therapy with remarkable therapeutic results and few side-effects.Therefore,this treatment can significantly improve the patient's living quality.
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Objective To explore the effectiveness of a new kind of embolization agent-sodium alginate(KMG), and to evaluate the clinical value of 2D color Dopper ultrasound in assessing the therapeutic effect of uterin arterial embolization (UAE) in leiomyomas. Methods Forty nine patients with symptomatic leiomyomas were undertaken UAE with KMG for the treatment. Sonography was performed at 3 ～ 7 days before and,1,3,6 months after UAE with 2D color Doppler for evaluating the 2D echograms and hemodymamics. Results Forty nine leiomyomas were studied after UAE,showing a marked reduction in the size(35% - 90%). No blood flow was demonstrated in the leiomyomas either 3 - 7 days or 1 month or 3 months after the procedurc. The reappearance of blood flow could be seen in only one case. Conclusion KMG is an efficient embolization agent for the treatment of symptomatic leiomyomas with UAE,and ultrasonography is a useful tool to assess the effectiveness. (J Intervent Radiol, 2006, 15: 469-471)
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Objective To evaluate the effectiveness of uterine arterial embolization (UAE) in the management of uterine fibroids (UF) and adenomyoma. Methods The UAE was carried out in 22 cases of UF and 2 cases of adenomyoma, including bilateral UAE in 23 cases and unilateral UAE in 1 case, by using polyvinyl alcohol (PVA) particles as embolic materials. Results The success rate of UAE in the study was 95 8% (23/24). No serious complications occurred. The uterine and UF volume decreased remarkably in size 6 months after the treatment ( t =2 391 and 3 990, respectively; P =0 022 and 0.000, respectively). In the patient who underwent unilateral UAE, the UF gradually increased in size and a hysterectomy was required. The 2 patients with adenomyoma experienced relief with this treatment but had a recurrence 4 months after the surgery. Conclusions UAE is a safe and effective method in the management of UF but its long-term effects remains a question to be answered through further observations . The efficacy of treatment of this method for adenomyoma is not apparent.
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Objective To discuss the nursing care for patients with placenta previa,who receive uterine arterial catheterization and embolization in the second trimester of pregnancy. Methods By using superselective catheterization with Seldinger technique,bilateral uterine artery angiography and embolization were performed in 16 patients with placenta previa in the second trimester of pregnancy. Two to four hours after the procedure,rivanol intra-amniotic injection was employed to induce the abortion. Close perioperative observation and careful nursing were carried out. Results The fetus with its subsidiary tissue was delivered in a mean time of 4.5 hours after the operation in 15 cases. No postpartum hemorrhage occurred. Induced abortion failed in one case with 26 weeks pregnancy because of a scar uterus and cervical dystocia. Hysterotomy was performed 6 days later,blood loss during the operation was about 100 ml. No nursing care related complications occurred in all 16 patients. Conclusion Uterine arterial embolization is very helpful in making the induced abortion for the treatment of bleeding placenta previa in the second trimester of pregnancy. Strengthening of perioperative care can improve successful rate of interventional therapy and prevent the occurrence of complication.
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Objective To investigate the effect of hysterectomy and uterine arterial embolization on the function of ovary.Methods The serum concentrations of estrin(E2), progestogen(P),fouicule-stimulating hormone(FSH),luteotropic hormone(LH) and prolaction(PRL) were measured in 18 patients undergone hysterectomy (group Ⅰ),15 patients undergone uterine arterial emboliation(group Ⅱ) and 30normal women (group Ⅲ or control group).These five hormones were compared in each group.Results The serum concentrations of E2 and P in the group Ⅰ were lower than that in group Ⅲ, there was significant difference between them.The serum concentrations of E2 and P in group Ⅱ and group Ⅲ was no significant difference.Conclusion Hysterectomy has significant effects on the function of ovary,while uterine arterial embolization has not.
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Objective To investigate the effects of uterine resection and uterine arterial embolization on the function of ovary. Methods The serum concentrations of estrin(E 2), progestogen(P), follicule stimulating hormone(FSH), luteotropic hormone(LH) and prolactin(PRL) were measured in 15 patients with uterine resection and 22 patients with uterine arterial embolization; including 23 patients with uterine leiomyoma and 29 normal women. We compared the results of the five hormones in each group. Results The serum concentrations of E 2 and P in the group of uterine resection were lower than the normal control group, there was a significant difference between them. Compared the serum concentrations of E 2 and P in the group of uterine arterial embolization and normal control group, there was no significant difference. The serum concentration of PRL in the group of uterine leiomyoma was higher than the normal control group with significant difference. When the uterus was resected or uterine artery was embolished, the serum concentration of PRL decreased remarkably. Conclusions Uterine resection has effects on the function of ovary, but uterine arterial embolization would not. PRL may be one of the factors causing the formation of uterine leiomyoma.
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Objective To analyze the clinical data of selective uterine arterial embolization in treating uterine leiomyoma retrospectively. Methods Super-selective arterial embolization were performed using Seldinger's technique. The degree of shrinkage of uterine and leiomyoma were measured, and the influence of the treatment on ovarian function was analysed as well. Results After embolization, uterine and leiomyoma significantly shrinked. Uterine leiomyoma artery embolization(UAE) had no influence on ovarian function. Conclusions UAE is an effective method in treating uterine leiomyoma.
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Objective To discuss the therapeutic effect of uterine arterial embolization in treating adenomyosis.Methods Uterine arterial embolization was performed in 80 patients with adenomyosis.The patients were followed up for 3,6,12 and 24 months after the operation.After the treatment the degree of dysmenorrhea,the menstrual flow and the uterine volume were observed and were compared with those before the treatment.Results After uterine arterial embolization the clinical symptoms were relieved in all 80 patients.The menstrual flow was markedly decreased,the anemia was obviously improved and the uterine volume was significantly reduced,while the ovary functioning was not apparently affected.The symptom of dysmenorrhea completely disappeared one month after the therapy in 76 cases and four months after the therapy in the remaining 4 cases.Conclusion Uterine arterial embolization is a mini-invasive and safe therapy with remarkable therapeutic results and few side-effects.Therefore,this treatment can significantly improve the patient’s living quality.
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Objective To investigate the possibility of interventional treatment of placenta accreta. Methods One patient with placenta accreta was treated with uterine arterial infusion of cef and MTX followed by embolization. Results Her placenta discharged through vagina at the 27th day after uterine aterial embolizayiea. No remnant was found in the uterine by Doppler imaging. The patient uneventfully recovered.Conclusions Intervetional therapy with uterine arterial embolization is a new and reliable method for treatment of placenta accheta.