Diagnostic multimodal imaging and therapeutic transcatheter arterial chemoembolization for conservative management of hemorrhagic cesarean scar pregnancy

Cesarean scar ectopic pregnancy: imaging features, current treatment options, and clinical outcomes

“…Although currently not performed at our institution for treatment of CSEP or cervical ectopic pregnancies, several authors have described its utility and efficacy [37][38][39]. Isolated UAE has not been described in the literature, but is always used in conjunction with suction curettage [37], intra-arterial MTX [40], or polyvinyl alcohol particles [41].…”

Angiographic uterine artery chemoembolization followed by vacuum aspiration: an efficient and safe treatment for managing complicated cesarean scar pregnancy

“…The cesarean section scar is perfused mainly by the uterine arteries, UAEC can achieve adequate hemostasis immediately by interrupt the arterial supply. However, after the complete occlusion of uterine arteries by UAEC, necrosis of villus tissues does not occur solely and the extensive collateral circulation will be established quickly, which will supply blood to the cesarean scar placental tissue again through either recanalization of the feeding vessels or collateral neovascularization [14,15]. In addition, this may cause reappearance of vaginal bleeding might occur.…”

Cervico-Isthmic Pregnancy: Early Diagnostic Imaging and Successful Dual Therapy for Uterine-Sparing Treatment

“…After receiving counseling on the potential risk of hemorrhage during conservative management, the patient strongly wished to preserve her uterus and opted to undergo TACE [11] as an initial conservative measure to devascularize the ectopic gestational products.…”

“…On the arterial phase of sagittal 3-dimensional computed tomography (CT) angiography [11] performed for further assessment of the uteroplacental neovascularization around the gestational products, a prominent vascular lesion (Fig. 3C, arrow) with feeding branches from bilateral uterine arteries was identified in the lower uterine segment.…”

“…Here we report a rare case of early cervico-isthmic pregnancy complicated with massive hematometra, which was diagnosed by multimodal imaging and managed by hysteroscopic resection after transcatheter arterial chemoembolization (TACE) [11]. The Gifu Prefectural Tajimi Hospital's Institutional Review Board approved this report.…”