Clinical analysis of high-intensity focused ultrasound (HIFU) combined with hysteroscopy-guided suction curettage (HGSC) in patients with cervical pregnancy

Figures & data

Figure 1. A representative ultrasound image of cervical pregnancy. The red arrow is showing a gestational sac, and the white arrow is showing off the germ. The gestation is located in the cervical canal, but the uterine cavity was empty (yellow arrow).

Figure 2. Color flow Doppler imaging demonstrated successful removal of the gestational tissue. (A) Contrast-enhanced Ultrasound was performed before HIFU, which shows of obvious perfusion of the gestational sac existed (white arrow). (B) Contrast-enhanced Ultrasound was performed again after HIFU treatment, and it shows no obvious perfusion agent was detected in the gestational sac tissue (white arrow).

Table 1. Baseline clinical characteristics of seven patients with cervical pregnancy treated with HIFU combined with HGSC.

	Case 1	Case 2	Case 3	Case 4	Case 5	Case 6	Case 7	Average
Age (years)	32	27	43	33	30	26	29	31 ± 6
Duration of amenorrhea (days)	60	44	58	48	49	38	40	48 ± 8
Gravidity (times)	6	3	5	4	8	2	2	4 ± 2
Parity (times)	1	1	1	1	1	0	2	1 ± 1
Cesarean section history (times)	0	2	4	3	7	2	0	3 ± 2
Diameter of gestational sac (cm)	3.80	1.95	0.75	1.05	2.67	0.90	0.85	2 ± 1
Hemoglobin level before treatment (g/L)	124	122	119	73	128	114	120	114 ± 19
β-HCG level before treatment (mIU/mL)	93911	24789	9752	51402	71813	8239	32506	41773 ± 32242

Data are presented as mean ± standard deviation.

Table 2. Ultrasound parameters of HIFU treatment on seven patients.

	Case 1	Case 2	Case 3	Case 4	Case 5	Case 6	Case 7	Average
Ultrasound energy (J)	240400	160000	160000	144000	101200	51600	50000	129600 ± 67773
Ultrasound power (W)	400	400	400	400	400	356	400	394 ± 17
Ultrasound treatment time (s)	601	400	400	360	253	145	125	326 ± 166

Data are presented as mean ± standard deviation.

Table 3. Clinical parameters of suction curettage for seven patients.

	Case 1	Case 2	Case 3	Case 4	Case 5	Case 6	Case 7	Average
Bleeding volume (mL)	20	10	3	20	10	2	2	10 ± 8
Duration of surgery (min)	18	9	30	10	20	32	25	21 ± 9
Time between HIFU and suction curettage (days)	1	2	3	2	2	1	1	2 ± 1

Data are presented as mean ± standard deviation.

Table 4. Follow-up observations after HIFU and HGSC treatments.

	Case 1	Case 2	Case 3	Case 4	Case 5	Case 6	Case 7	Average
β-HCG (mIU/mL) after treatments	17700	6896	7872	25452	21727	3303	8758	13101 ± 8454
Time between surgery and normal β-HCG (days)	40	25	35	20	40	25	15	29 ± 10
Duration of vaginal bleeding (days)	5	15	10	14	7	20	15	12 ± 5
Time of return of normal menstruation (days)	45	30	45	30	50	31	32	38 ± 9

Data are presented as mean ± standard deviation.