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Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space

Methotrexate has been the main mode of non-surgical treatment for ectopic pregnancies. However, we have developed an easier, repeatable method that can be applied even to patients with a high beta-human chorionic gonadotropin (β-hCG) level and/or positive fetal heartbeat, by targeting chorionic vill...

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Autores principales: Osada, Hisao, Teramoto, Shokichi, Kaijima, Hirotsune, Segawa, Tomoya, Nagaishi, Masaji, Shozu, Makio, Kato, Keiichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400639/
https://www.ncbi.nlm.nih.gov/pubmed/32659901
http://dx.doi.org/10.3390/biomedicines8070202
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author Osada, Hisao
Teramoto, Shokichi
Kaijima, Hirotsune
Segawa, Tomoya
Nagaishi, Masaji
Shozu, Makio
Kato, Keiichi
author_facet Osada, Hisao
Teramoto, Shokichi
Kaijima, Hirotsune
Segawa, Tomoya
Nagaishi, Masaji
Shozu, Makio
Kato, Keiichi
author_sort Osada, Hisao
collection PubMed
description Methotrexate has been the main mode of non-surgical treatment for ectopic pregnancies. However, we have developed an easier, repeatable method that can be applied even to patients with a high beta-human chorionic gonadotropin (β-hCG) level and/or positive fetal heartbeat, by targeting chorionic villi with a transvaginal injection of absolute ethanol (AE) into the lacunar space (intervillous space). The efficacy and safety of this method were examined in 242 cases of ectopic pregnancy, including 103 with positive fetal heartbeat. Serum β-hCG level was measured at frequent intervals, and transvaginal ultrasonography was performed to observe the gestational sac and hyperechoic inner ring. Of the 242 patients, 222 (91.7%) were successfully treated. The average number of AE injection(s) required was 1.6 (range: 1–5), and the average dose was 3.2 mL. After the treatment, many of the patients tried to conceive again, and 63 of the traceable 145 patients (43.4%), who had fallopian tube pregnancy, and 7 of the traceable 12 patients (58.3%), who had cervical or cesarean scar pregnancies, successfully conceived and delivered babies with no observed side effects. Therefore, this method could be an effective treatment for ectopic pregnancy with the potential to replace conventional surgical interventions and medical treatment using methotrexate.
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spelling pubmed-74006392020-08-07 Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space Osada, Hisao Teramoto, Shokichi Kaijima, Hirotsune Segawa, Tomoya Nagaishi, Masaji Shozu, Makio Kato, Keiichi Biomedicines Article Methotrexate has been the main mode of non-surgical treatment for ectopic pregnancies. However, we have developed an easier, repeatable method that can be applied even to patients with a high beta-human chorionic gonadotropin (β-hCG) level and/or positive fetal heartbeat, by targeting chorionic villi with a transvaginal injection of absolute ethanol (AE) into the lacunar space (intervillous space). The efficacy and safety of this method were examined in 242 cases of ectopic pregnancy, including 103 with positive fetal heartbeat. Serum β-hCG level was measured at frequent intervals, and transvaginal ultrasonography was performed to observe the gestational sac and hyperechoic inner ring. Of the 242 patients, 222 (91.7%) were successfully treated. The average number of AE injection(s) required was 1.6 (range: 1–5), and the average dose was 3.2 mL. After the treatment, many of the patients tried to conceive again, and 63 of the traceable 145 patients (43.4%), who had fallopian tube pregnancy, and 7 of the traceable 12 patients (58.3%), who had cervical or cesarean scar pregnancies, successfully conceived and delivered babies with no observed side effects. Therefore, this method could be an effective treatment for ectopic pregnancy with the potential to replace conventional surgical interventions and medical treatment using methotrexate. MDPI 2020-07-09 /pmc/articles/PMC7400639/ /pubmed/32659901 http://dx.doi.org/10.3390/biomedicines8070202 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Osada, Hisao
Teramoto, Shokichi
Kaijima, Hirotsune
Segawa, Tomoya
Nagaishi, Masaji
Shozu, Makio
Kato, Keiichi
Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space
title Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space
title_full Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space
title_fullStr Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space
title_full_unstemmed Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space
title_short Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space
title_sort managing ectopic pregnancies by targeting chorionic villi with a transvaginal injection of ethanol into the lacunar space
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400639/
https://www.ncbi.nlm.nih.gov/pubmed/32659901
http://dx.doi.org/10.3390/biomedicines8070202
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