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Updated: Jun 5, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Conservative management of cervical ectopic pregnancy: utility of uterine artery embolization
Mark A Zakaria1, Mazen E Abdallah, Valerie I Shavell
1Division of Gynecology, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan 48201, USA. mzakaria@med.wayne.edu
Objective:
To evaluate the use of uterine artery embolization (UAE) in conjunction with methotrexate in the conservative treatment of cervical ectopic pregnancy (CEP).
Design:
Case series.
Setting:
Tertiary-care university hospital.
Patient(S):
Cases of CEP treated at Hutzel Women's Hospital between January 1997 and December 2008.
Intervention(S):
Multidose methotrexate treatment with or without UAE and intra-amniotic potassium chloride injection (KCl).
Main Outcome Measure(S):
Beta-human chorionic gonadotropin level, vaginal bleeding, length of hospital stay, and future fecundity.
Result(S):
A retrospective analysis of 15 patients with CEP treated conservatively using methotrexate with leucovorin rescue (MTx/Leu) alone (group 1, five cases), with UAE as an adjunctive therapy (group 2, six cases), or also having received intra-amniotic KCl before UAE (group 3, four cases) is reported. There was no significant difference in age, parity, or gestational age among treatment groups. The median β-hCG level on presentation was 9,606 mIU/mL for group 1, 26,516 mIU/mL for group 2, and 130,464 mIU/mL for group 3. The difference was found to be statistically significant. No patients developed complications from UAE. Of the 10 patients who underwent UAE, 2 subsequently had confirmed viable pregnancies.
Conclusion(S):
Uterine artery embolization with methotrexate is an option for minimally invasive intervention in the treatment of CEP.
