The Management of Heterotopic Pregnancy with Transvaginal Ultrasound-Guided Local Injection of Absolute Ethanol

AIMS: The aim of the study is to present five cases of heterotopic pregnancy (HP) patients who received transvaginal ultrasound-guided local injection of absolute ethanol (AE). SETTINGS AND DESIGN: This was a case series and literature review in Reproductive Medicine Center of the 105(th) Hospital of the People's Liberation Army. MATERIALS AND METHODS: Five primary infertile women who underwent assisted reproductive technology were diagnosed with HP and treated with local injection of AE (1.0–2.5 ml) under transvaginal ultrasound guidance. The size of intrauterine (IU) and ectopic sacs and the level of serum beta-human chorionic gonadotropin as well as pregnancy outcomes were monitored after treatment. STATISTICAL ANALYSIS USED: Not applicable. RESULTS: Four of five cases presented with lack of Doppler flow in the injected area after AE injection. Meanwhile, IU pregnancy proceeded well after treatment and delivered a normal newborn. One case received emergency surgery 3 h after local injection of 2.5 ml AE because of the rupture of ectopic gestational sac (GS). An early abortion was identified 7 days after the surgery. CONCLUSIONS: Transvaginal ultrasound-guided local injection of AE is an alternative nonsurgical treatment for HP, yet overdose injection of AE will increase the risk of ectopic GS rupture.