Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2023; 11(4): 788-796
Published online Feb 6, 2023. doi: 10.12998/wjcc.v11.i4.788
Efficacy of transvaginal ultrasound-guided local injections of absolute ethanol for ectopic pregnancies with intrauterine implantation sites
Toshiyuki Kakinuma, Kaoru Kakinuma, Yoshio Matsuda, Kaoru Yanagida, Michitaka Ohwada, Hirotsune Kaijima
Toshiyuki Kakinuma, Kaoru Kakinuma, Yoshio Matsuda, Kaoru Yanagida, Michitaka Ohwada, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara 329-2763, Japan
Hirotsune Kaijima, Minatomirai Yume Clinic, Yokohama 2200012, Japan
Author contributions: Kakinuma T conceived, designed, and performed the analysis, and wrote the paper; all authors collected and contributed data/analysis tools; all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the International University of Health and Welfare Hospital Ethics Committee (referral number: 21-B-34).
Informed consent statement: Written informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: The authors have no relevant financial or non-financial interests to disclose.
Data sharing statement: The data are available upon reasonable request to the corresponding author.
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, Doctor, Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-City, Tochigi, Nasushiobara 329-2763, Japan. tokakinuma@gmail.com
Received: November 18, 2022
Peer-review started: November 18, 2022
First decision: December 13, 2022
Revised: December 27, 2022
Accepted: January 12, 2023
Article in press: January 12, 2023
Published online: February 6, 2023
ARTICLE HIGHLIGHTS
Research background

Ectopic pregnancy at cervical pregnancy, caesarean scar pregnancy, and interstitial pregnancy are rare; therefore, it is challenging to say that a standard treatment has been established.

Research motivation

Removal of ectopic pregnancies using methotrexate therapy and/or uterine artery embolization has been reported. However, delayed resumption of infertility treatments after methotrexate therapy is indicated, and negative effects on the next pregnancy after uterine artery embolization have been reported. To avoid these problems, we will establish a new treatment method for Cervical pregnancies, interstitial tubal pregnancies, and cesarean scar pregnancies, which are ectopic pregnancies with intrauterine implantation sites.

Research objectives

The purpose of this study was to examine the efficacy and safety of ultrasound-guided topical injection of absolute ethanol in ectopic pregnancies with an implantation site within the uterus.

Research methods

We retrospectively examined the medical records of 21 patients who were diagnosed with an ectopic pregnancy with an intrauterine implantation site at our hospital, between April 2010 and December 2018, and underwent transvaginal ultrasound-guided local injections of absolute ethanol to determine the treatment outcomes. We evaluated the treatment methods, treatment outcomes, presence of bleeding requiring hemostasis measures and blood transfusion, complications, and treatment periods.

Research results

All patients completed treatment with transvaginal ultrasound-guided local injections of absolute ethanol. No massive hemorrhaging or serious adverse reactions were observed during treatment.

Research conclusions

Transvaginal ultrasound-guided local injections of absolute ethanol could become a new option for intrauterine ectopic pregnancies when fertility preservation is desired.

Research perspectives

Ectopic pregnancy at cervical pregnancy, caesarean scar pregnancy, and interstitial pregnancy are rare; therefore, it is challenging to say that a standard treatment has been established. Transvaginal ultrasound-guided local injections of absolute ethanol for ectopic pregnancies such as cervical pregnancies, interstitial tubal pregnancies, and cesarean scar pregnancies can preserve the uterus without serious adverse reactions. This treatment avoids the complications caused by methotrexate therapy and uterine artery embolization. This treatment may become a new treatment option for intrauterine ectopic pregnancy when fertility preservation is desired.