L.E. TEREGULOVA¹^,², L.D. EGAMBERDIEVA³, N.I. TUKHVATSHINA¹, A.Yu. TEREGULOV³^,¹, A.V. POSTNIKOV¹

¹Republican Clinical Hospital of the Ministry of Health, 138 Orenburgskiy Trakt, Kazan, Russian Federation 420064

²Kazan State Medical Academy, 11 Mushtari St., Kazan, Russian Federation 420012

³Kazan State Medical University, 16 Butlerova St., Kazan, Russian Federation 420012

Teregulova L.E. — Candidate of Medical Science, Head of Department of ultrasonic diagnosis of Republican Clinical Hospital, assistant professor of the Department of ultrasonic diagnosis of Kazan State Medical Academy, tel. +7-917-269-58-41, e-mail: tereg1@mail.ru¹^,² 

Egamberdieva L.D. — Candidate of Medical Science, assistant professor of the Department of Obstetrics and Gynecology № 1 Kazan State Medical University, tel. +7-904-765-22-62, e-mail: lutsia1@yandex.ru³

Tykhvatshina N.I. — Head of the Department of Gynecology of Republican Clinical Hospital, tel. +7-903-313-71-78, e-mail: tuxvatshina@bx.ru¹

Teregulov A.Yu. — Candidate of Medical Science, assistant professor of the Department of oncology, radiation diagnosis and radiotherapy of KSMU, physician of X-ray surgery of Republican Clinical Hospital, tel. +7-917-269-58-40, e-mail: tereg@yandex.ru¹^,³

Postnikov A.V. — physician of the Department of X-ray surgery of Republican Clinical Hospital, tel. +7-960-048-11-98, e-mail: sasha-postnicov@inbox.ru¹

12 cases of differentiated organ preservation treatment of cervical pregnancy using proprietory diagnostic techniques and treatment are presented. Ultrasonic criteria of the chorion rotation in case of cervical pregnancy were revealed (unclear boundary of chorion, thickening of the chorion, reducing its echogenisity, visualization of blood flow in the chorion in B-mode, increase of blood flow in CDI, thinning of cervix). In 3 cases the signs of chorion rotation were found, and patients were successfully carried out a combination of minimally invasive organ-preserving methods of treatment (uterine arteries embolisation with intra-arterial injection of methotrexate and introduction of methotrexate in the gestational sac), leaving the frozen gestational sac in the cervix that afterwards resolved within three months. In 9 cases there were no signs of chorion rotation; in 4 cases there was conducted successful removal of gestational sac after preliminary uterine arteries embolisation; in 5 cases gestational sac was successfully removed in usual manner without prior uterine arteries embolization under conditions of operational .

Key words: cervical pregnancy, chorion rotation, ultrasound investigation, color Doppler imaging, uterine arteries embolisation, methotrexate.

 

 

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