Skip to main content

Advertisement

SpringerLink
Log in

Splenic pregnancy treated with transcatheter embolization and methotrexate

  • Review
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Primary splenic pregnancy is a rare entity, usually treated with splenectomy.

Case presentation and review of the literature

We report the first case of conservative management of splenic pregnancy with selective embolization and intramuscular methotrexate administration. Postoperative treatment was uneventful. We have further systematically reviewed the literature upon the treatment options in case of splenic pregnancy. It has been evident that most cases were treated with spleenectomy, especially in case of active hemorrhage. Spleen preservation is rarely achieved, only in cases of hemodynamically stable, uncomplicated patients.

Conclusion

Splenic selective embolization could be a treatment option in case of uncomplicated splenic pregnancy with the benefit of splenic preservation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N (2002) Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Human Reprod (Oxf, Engl) 17(12):3224–3230

    Article  CAS  Google Scholar 

  2. Poole A, Haas D, Magann EF (2012) Early abdominal ectopic pregnancies: a systematic review of the literature. Gynecol Obstet Invest 74(4):249–260. https://doi.org/10.1159/000342997

    Article  PubMed  Google Scholar 

  3. Zhang Y, Kang D, Zhang B, Yang L, Fan Z (2016) Ectopic pregnancy causing splenic rupture. Am J Emerg Med 34(6):1184.e1181–1182. https://doi.org/10.1016/j.ajem.2015.11.011

    Article  Google Scholar 

  4. Studdiford W (1942) Primary peritoneal pregnancy. Am J Obstet Gynecol 44:487–491

    Article  Google Scholar 

  5. Kitade M, Takeuchi H, Kikuchi I, Shimanuki H, Kumakiri J, Kinoshita K (2005) A case of simultaneous tubal-splenic pregnancy after assisted reproductive technology. Fertil Steril 83(4):1042. https://doi.org/10.1016/j.fertnstert.2004.10.047

    Article  PubMed  Google Scholar 

  6. Yagil Y, Beck-Razi N, Amit A, Kerner H, Gaitini D (2007) Splenic pregnancy: the role of abdominal imaging. J Ultrasound Med Off J Am Inst Ultrasound Med 26(11):1629–1632

    Google Scholar 

  7. Gang G, Yudong Y, Zhang G (2010) Successful laparoscopic management of early splenic pregnancy: case report and review of literature. J Minim Invasive Gynecol 17(6):794–797. https://doi.org/10.1016/j.jmig.2010.07.004

    Article  PubMed  Google Scholar 

  8. Python JL, Wakefield BW, Kondo KL, Bang TJ, Stamm ER, Hurt KJ (2016) Ultrasound-guided percutaneous management of splenic ectopic pregnancy. J Minim Invasive Gynecol 23(6):997–1002. https://doi.org/10.1016/j.jmig.2016.05.004

    Article  PubMed  Google Scholar 

  9. Klang E, Keddel N, Inbar Y, Rimon U, Amitai M (2016) Splenic pregnancy: a new minimally invasive approach to treatment. Cardiovasc Intervent Radiol 39(9):1339–1342. https://doi.org/10.1007/s00270-016-1403-5

    Article  PubMed  Google Scholar 

  10. Hu J, Tao X, Yin L, Shi Y (2016) Successful conservative treatment of cervical pregnancy with uterine artery embolization followed by curettage: a report of 19 cases. BJOG Int J Obst Gynaecol 123(Suppl 3):97–102. https://doi.org/10.1111/1471-0528.14005

    Article  Google Scholar 

  11. Coke GA, Baschat AA, Mighty HE, Malinow AM (2004) Maternal cardiac arrest associated with attempted fetal injection of potassium chloride. Int J Obst Anesth 13(4):287–290. https://doi.org/10.1016/j.ijoa.2004.04.009

    Article  CAS  Google Scholar 

  12. Weledji EP (2014) Benefits and risks of splenectomy. Int J Surg (Lond, Engl) 12(2):113–119. https://doi.org/10.1016/j.ijsu.2013.11.017

    Article  Google Scholar 

  13. Liatsos GD (2019) The immunity features and defects against primary cytomegalovirus infection post-splenectomy indicate an immunocompromised status: a PRISMA-compliant meta-analysis. Medicine 98(43):e17698. https://doi.org/10.1097/md.0000000000017698

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Medical School, University Hospital Heraklion, University of Crete, 71003, Heraklion, Crete, Greece

    Antonis Makrigiannakis, Thomas Vrekoussis, Stefania Patramani & Fanourios Makrygiannakis

  2. Interventional Radiology Unit, Department of Medical Imaging, Medical School, University Hospital Heraklion, University of Crete, Heraklion, Crete, Greece

    Maria Raissaki, Nelli Kholcheva & Dimitrios Tsetis

Authors
  1. Antonis Makrigiannakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Raissaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas Vrekoussis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stefania Patramani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fanourios Makrygiannakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nelli Kholcheva
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Dimitrios Tsetis
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AM and DT conceived the presented clinical approach. All authors participated in patient management, and clinical data acquisition. Literature search was performed by TV and FM. Initial draft was prepared by TV, FM and AM. All authors revised it critically for important intellectual content. All authors approved the version to be published. All authors agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Antonis Makrigiannakis.

Ethics declarations

Conflict of interest

We declare that we have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Makrigiannakis, A., Raissaki, M., Vrekoussis, T. et al. Splenic pregnancy treated with transcatheter embolization and methotrexate. Arch Gynecol Obstet 303, 55–59 (2021). https://doi.org/10.1007/s00404-020-05778-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05778-x

Keywords

Search

Navigation