Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6128-6135
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6128
Effectiveness and safety of ultrasound-guided intramuscular lauromacrogol injection combined with hysteroscopy in cervical pregnancy treatment: A case report
Jian-Pei Ye, Yang Gao, Li-Wei Lu, Yong-Ju Ye
Jian-Pei Ye, Department of Ultrasonography, Lishui Hospital of Traditional Chinese Medicine, Lishui 323000, Zhejiang Province, China
Yang Gao, Li-Wei Lu, Yong-Ju Ye, Department of Gynaecology, Lishui Hospital of Traditional Chinese Medicine, Lishui 323000, Zhejiang Province, China
Author contributions: Ye YJ and Gao Y wrote the introduction and discussion sections; Ye YJ and Ye JP performed the review of the literature and wrote the case report; Ye YJ and Lu LW revised the manuscript.
Informed consent statement: The patient agreed to the publication of this report and provided informed consent.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
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: Yong-Ju Ye, Doctor, MCh, MD, MS, Chief Physician, Department of Gynaecology, Lishui Hospital of Traditional Chinese Medicine, No. 800 Zhongshan Street, Liandu District, Lishui 323000, Zhejiang Province, China. ls8558@163.com
Received: November 3, 2021
Peer-review started: November 3, 2021
First decision: February 21, 2022
Revised: February 23, 2022
Accepted: April 20, 2022
Article in press: April 20, 2022
Published online: June 26, 2022
Processing time: 225 Days and 12.7 Hours
Abstract
BACKGROUND

Cervical pregnancy is increasing in morbidity, and a definite diagnosis in early stages is challenging due to its specific onset site. Surgery is the mainstay of treatment for cervical pregnancy, but it may result in the loss of natural fertility. Therefore, it is a great challenge to pursue a safe and effective treatment for cervical pregnancy.

CASE SUMMARY

We report the case of a cervical pregnancy successfully treated by ultrasound-guided cervical-intramuscular lauromacrogol injection combined with hysteroscopy. A 23-year-old woman with minor irregular vaginal bleeding was admitted to our department with suspected ectopic pregnancy. Transvaginal ultrasound revealed a gestational sac (approximately 22 mm x 13 mm) situated in the cervical canal with a yolk sac and blood flow signals. No cardiac activity was detected. Serum beta progesterone was 17.06 ng/mL, and serum beta human chorionic gonadotropin (β-HCG) was 5077.0 IU/L. The patient was diagnosed with cervical pregnancy. She was treated by ultrasound-guided cervical-intramuscular injections of lauromacrogol (3 mL) in combination with aborting under hysteroscopic visualization. A gradual decrease in β-HCG levels and normal ultrasound findings were observed. Postoperative pathologic examination showed the presence of villi and changes in the endometrium in the secretory phase. The patient was discharged on day 6, and her β-HCG level was 0.67 mIU/mL after 1 wk. There was no statistical difference between baseline and 1-week postoperative data in terms of serum indices including liver function, renal function, and routine blood analysis after treatment. The patient subsequently became pregnant 2 mo later and no abnormalities were detected on routine screening during pregnancy.

CONCLUSION

Ultrasound-guided cervical-intramuscular lauromacrogol injection combined with hysteroscopy may be effective and safe in the treatment of cervical pregnancy.

Keywords: Cervical pregnancy; Lauromacrogol; Hysteroscopy; Effectiveness; Safety; Case report

Core Tip: This study reports a typical clinical case of cervical pregnancy who received a conservative treatment combining ultrasound-guided lauromacrogol injection with hysteroscopy. The effectiveness and safety of the conservative treatment were evaluated, and the patient obtained a good outcome.