Kakinuma T, Kakinuma K, Matsuda Y, Ohwada M, Yanagida K, Kaijima H. Ultrasound-guided local ethanol injection for fertility-preserving cervical pregnancy accompanied by fetal heartbeat: Two case reports. World J Clin Cases 2022; 10(11): 3587-3592 [PMID: 35582054 DOI: 10.12998/wjcc.v10.i11.3587]
Corresponding Author of This Article
Toshiyuki Kakinuma, MD, PhD, Professor, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara 329-2763, Japan. kakinuma@iuhw.ac.jp
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Toshiyuki Kakinuma, Kaoru Kakinuma, Yoshio Matsuda, Michitaka Ohwada, Kaoru Yanagida, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
Hirotsune Kaijima, Minatomirai Yume Clinic, Yokohama 220-0012, Japan
Author contributions: Kakinuma T designed the research study and wrote the manuscript; Kakinuma T, Kakinuma K, Ohwada M and Yanagida K performed the research; Matsuda Y and Kaijima H provided help and advice on the study protocol; All authors read and approved the final manuscript.
Informed consent statement: The study was approved by the Ethics Committee of the International University of Health and Welfare Hospital (Approval date: July 21, 2021; Approval number 21-B-8). The patients provided consent after receiving written and verbal explanation of the study protocol.
Conflict-of-interest statement: The authors declare no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshiyuki Kakinuma, MD, PhD, Professor, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara 329-2763, Japan. kakinuma@iuhw.ac.jp
Received: December 1, 2021 Peer-review started: December 1, 2021 First decision: January 22, 2022 Revised: February 7, 2022 Accepted: February 27, 2022 Article in press: February 27, 2022 Published online: April 16, 2022 Processing time: 127 Days and 21.3 Hours
Abstract
BACKGROUND
The incidence of cervical pregnancy is increasing due to the recent widespread application of assisted reproductive technology. Although hysterectomy has been a treatment option, high-sensitivity human chorionic gonadotropin testing and improved accuracy of transvaginal ultrasound imaging have increased possibility of uterine preservation. Dilation and curettage with methotrexate therapy and uterine artery embolization have been reported as treatments with fertility preservation; however, certain disadvantages limit their use.
CASE SUMMARY
In our two reported cases, we avoided massive bleeding and immediately resumed infertility treatment using ultrasound-guided local ethanol injection for cervical pregnancies with fetal heartbeats.
CONCLUSION
This treatment may be a new fertility-preserving option for cervical pregnancy.
Core Tip: We describe the use of transvaginal ultrasound-guided local injection of absolute ethanol as a new treatment method for cervical pregnancy that preserves fertility. In both cases, the patients had developed cervical pregnancy through assisted reproductive technology and sought fertility-preserving treatment. A local injection of absolute ethanol allowed resumption of menstruation 2 mo after treatment and early resumption of infertility treatment without any complications. We suggest that local injection of absolute ethanol for cervical pregnancy could be a safe and effective new treatment method.
