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Article

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

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Natural ART Clinic Nihombashi, 8F Tokyo Nihombashi Tower, 2-7-1 Nihombashi, Chuo-ku, Tokyo 103-6008, Japan
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Minatomirai Yume Clinic, 2F MM Park Building, 3-6-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa 220-0012, Japan
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Shimbashi Yume Clinic, EXCEL Shimbashi, 2-5-1, Shimbashi, Minato-ku, Tokyo 105-0004, Japan
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Department of Obstetrics and Gynecology, School of Medicine, Nihon University, 30-1 Ohyaguchi Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan
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Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba Prefecture, Chiba 260-0876, Japan
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Kato Ladies Clinic, Westgate Shinjuku Building, 7-20-3, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
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Author to whom correspondence should be addressed.
Biomedicines 2020, 8(7), 202; https://doi.org/10.3390/biomedicines8070202
Received: 2 June 2020 / Revised: 5 July 2020 / Accepted: 6 July 2020 / Published: 9 July 2020
(This article belongs to the Section Molecular and Translational Medicine)
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. View Full-Text
Keywords: chorionic villi-targeted therapy; ectopic pregnancies; absolute ethanol; nonsurgical management; transvaginal ultrasonography; methotrexate chorionic villi-targeted therapy; ectopic pregnancies; absolute ethanol; nonsurgical management; transvaginal ultrasonography; methotrexate
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MDPI and ACS Style

Osada, H.; Teramoto, S.; Kaijima, H.; Segawa, T.; Nagaishi, M.; Shozu, M.; Kato, K. Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space. Biomedicines 2020, 8, 202. https://doi.org/10.3390/biomedicines8070202

AMA Style

Osada H, Teramoto S, Kaijima H, Segawa T, Nagaishi M, Shozu M, Kato K. Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space. Biomedicines. 2020; 8(7):202. https://doi.org/10.3390/biomedicines8070202

Chicago/Turabian Style

Osada, Hisao, Shokichi Teramoto, Hirotsune Kaijima, Tomoya Segawa, Masaji Nagaishi, Makio Shozu, and Keiichi Kato. 2020. "Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space" Biomedicines 8, no. 7: 202. https://doi.org/10.3390/biomedicines8070202

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