Clinical efficacy and safety of cervical pregnancy treated with high-intensity focused ultrasound versus uterine artery embolization prior to ultrasound-guided suction curettage: a retrospective study.

OBJECTIVE This study aimed to retrospectively evaluate the efficacy and safety of high-intensity focused ultrasound (HIFU) versus uterine artery embolization (UAE) as pretreatment prior to ultrasound-guided suction curettage in the management of cervical pregnancy.

METHODS A retrospective review was conducted on 41 patients diagnosed with cervical pregnancy. Among them, 20 patients underwent UAE and 21 received HIFU treatment, both followed by ultrasound-guided suction curettage.

RESULTS None of the 41 patients required additional interventions due to active uterine bleeding following curettage. No significant differences were observed between the two groups in terms of age, number of previous abortions, days of amenorrhea, pretreatment serum β-hCG levels, average diameter of the gestational sac/mass, or blood loss during curettage (p > .05). Compared to the UAE group, the HIFU group exhibited significantly lower hospitalization costs, shorter hospital stays, and less pain intensity (p < .05). In the UAE group, 7 out of 20 patients experienced reduced menstrual flow; among them, 5 patients with fertility intentions underwent hysteroscopic adhesiolysis, resulting in 2 successful pregnancies. Of the remaining 13 patients in the UAE group without menstrual changes, 2 patients with fertility intentions achieved pregnancy. In the HIFU group, no patients reported alterations in menstrual volume. Among 10 patients with fertility intentions, 9 patients had pregnancies.

CONCLUSIONS In this pilot retrospective study, both UAE and HIFU demonstrated efficacy as pretreatment modalities prior to ultrasound-guided suction curettage for cervical pregnancy. HIFU showed potential advantages in pain reduction, hospitalization days, hospitalization expenses, and fertility preservation. These preliminary findings warrant validation in larger, prospective, multi-center trials.