Ectopic Pregnancy

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Focused Ultrasound Therapy

Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with ectopic pregnancy. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.

How it Works
Where the beams converge, focused ultrasound produces precise ablation (thermal destruction of tissue) enabling the ectopic pregnancy to be treated without surgery. While some treatments of ectopic pregnancy have been reported, further research is needed before this can become routinely available.

Advantages
The primary options for treatment of ectopic pregnancy will sometimes require surgery.

For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.

Clinical Trials

At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of ectopic pregnancy.

Regulatory Approval and Reimbursement

Focused ultrasound treatment for ectopic pregnancy is not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

Wang Z, Chang Y, Li S. Efficacy and Safety of High-intensity Focused Ultrasound Compared with Uterine Artery Embolization in Cesarean Section Pregnancy: A Meta-analysis. J Minim Invasive Gynecol. 2023 Nov;30(11):931-932. doi: 10.1016/j.jmig.2023.07.014. Epub 2023 Aug 14. PMID: 37586477 

Li H, Tan H. Regarding “Efficacy and Safety of High-intensity Focused Ultrasound Compared with Uterine Artery Embolization in Cesarean Section Pregnancy: A Meta-analysis”. J Minim Invasive Gynecol. 2023 Nov;30(11):931. doi: 10.1016/j.jmig.2023.07.016. Epub 2023 Aug 27. PMID: 37643660 

Mu L, Weng H, Dong Y. Analysis of risk factors for patients with cesarean scar pregnancy treated with methotrexate combined with suction curettage. Arch Gynecol Obstet. 2023 Sep;308(3):913-918. doi: 10.1007/s00404-023-07049-x. Epub 2023 May 2. PMID: 37131042 

Mu L, Weng H, Dong Y. Analysis of risk factors for patients with cesarean scar pregnancy treated with methotrexate combined with suction curettage. Arch Gynecol Obstet. 2023 Sep;308(3):913-918. doi: 10.1007/s00404-023-07049-x. Epub 2023 May 2. PMID: 37131042

Liu Y, Wang L, Zhu X. Efficacy and Safety of High-intensity Focused Ultrasound Compared with Uterine Artery Embolization in Cesarean Section Pregnancy: A Meta-analysis. J Minim Invasive Gynecol. 2023 Jun;30(6):446-454. doi: 10.1016/j.jmig.2023.02.021. Epub 2023 Mar 7. PMID: 36893898 

Li Y, Hua C. Is High-intensity Focused Ultrasound Superior to Uterine Artery Embolization in Cesarean Scar Pregnancy and Subsequent Pregnancy Outcomes? A Meta-analysis of the Chinese Population. J Minim Invasive Gynecol. 2023 Mar;30(3):180-191. doi: 10.1016/j.jmig.2022.11.015. Epub 2022 Nov 26.

Mm YL, Bm LW, Postdoc XZ. Efficacy and safety of high-intensity focused ultrasound compared with uterine artery embolization in caesarean section pregnancy: A meta-analysis. J Minim Invasive Gynecol. 2023 Mar 7:S1553-4650(23)00076-6. doi: 10.1016/j.jmig.2023.02.021.

Peng Y, Dai Y, Yu G, Jin P. High-intensity focused ultrasound ablation combined with systemic methotrexate treatment of intramural ectopic pregnancy: A case report. Medicine (Baltimore). 2022 Nov 18;101(46):e31615. doi: 10.1097/MD.0000000000031615.

Wang W, Chen Y, Yang Y, Qu D, Jiang J. High-intensity focused ultrasound compared with uterine artery chemoembolization with methotrexate for the management of cesarean scar pregnancy. Int J Gynaecol Obstet. 2022 Sep;158(3):572-578. doi: 10.1002/ijgo.14036. Epub 2021 Dec 5.

Chen H, Tan X, Xiong W, Wang X. High-intensity focused ultrasound for uterine arteriovenous malformation associated with retained products of conception: A case report. Asian J Surg. 2022 Jul 22:S1015-9584(22)00971-X. doi: 10.1016/j.asjsur.2022.07.026.

Liu Y, Yin Q, Xu F, Luo S. Clinical efficacy and safety of high-intensity focused ultrasound (HIFU) ablation in treatment of cesarean scar pregnancy (CSP) I and II. BMC Pregnancy Childbirth. 2022 Jul 30;22(1):607. doi: 10.1186/s12884-022-04848-z.

Guan X, Huang X, Ye M, Huang G, Xiao X, Chen J. Treatment of Placenta Increta With High-Intensity Focused Ultrasound Ablation and Leaving the Placenta in situ: A Multicenter Comparative Study. Front Med (Lausanne). 2022 Apr 7;9:871528. doi: 10.3389/fmed.2022.871528. eCollection 2022.

Zhu XG, Shi QL, Deng XL, Xu W, Xue M. Clinical effect and influencing factors of focused ultrasound ablation surgery combined with suction curettage for the treatment of mass-type cesarean scar pregnancy. Zhonghua Fu Chan Ke Za Zhi. 2022 Apr 25;57(4):253-258. doi: 10.3760/cma.j.cn112141-20210902-00483.

Diakosavvas M, Kathopoulis N, Angelou K, Chatzipapas I, Zacharakis D, Kypriotis K, Grigoriadis T, Protopapas A. Hysteroscopic treatment of Cesarean Scar Pregnancy: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2022 Mar;270:42-49. doi: 10.1016/j.ejogrb.2021.12.038. Epub 2022 Jan 5.

Mu L, Weng H, Wang X. Evaluation of the treatment of high intensity focused ultrasound combined with suction curettage for exogenous cesarean scar pregnancy. Arch Gynecol Obstet. 2022 Mar 18. doi: 10.1007/s00404-022-06487-3.

Yin Y, Pan F, He M, Zhang C, Liu Y. High intensity focused ultrasound combined with ultrasound-guided suction curettage treatment for cesarean scar pregnancy: a comparison of different HIFU sonication strategies. Int J Hyperthermia. 2022;39(1):390-396. doi: 10.1080/02656736.2022.2044078.

Legris ML, Gabriele V, Host A, Akladios C, Garbin O, Lecointre L. Cesarean scar pregnancy: Two case report and therapeutic management algorithm. J Gynecol Obstet Hum Reprod. 2021 Apr;50(4):102056. doi: 10.1016/j.jogoh.2020.102056. Epub 2021 Jan 2.

Mi W, Pei P, Zheng Y. Clinical efficacy and safety between high-intensity focused ultrasound and uterine artery embolization for cesarean scar pregnancy: a systematic review and a meta-analysis. Ann Palliat Med. 2021 Jun;10(6):6379-6387. doi: 10.21037/apm-21-839.

Liu CN, Tang L, Sun Y, Liu YH, Yu HJ. Clinical outcome of high-intensity focused ultrasound as the preoperative management of cesarean scar pregnancy. Taiwan J Obstet Gynecol. 2020 May;59(3):387-391. doi: 10.1016/j.tjog.2020.03.009.

Huo X, Xie Y, Yang L, Deng K, Liu Y. Doppler Ultrasound Evaluation of the Efficacy of High Intensity Focused Ultrasound in Treatment of Cesarean Section Scar Pregnancy. J Coll Physicians Surg Pak. 2020 Mar;30(3):240-244. doi: 10.29271/jcpsp.2020.03.240.

Qian H, Tian G, Zheng H, Liang W, Jiang T. Successful management of diaphragmatic ectopic pregnancy using ultrasound-guided percutaneous microwave ablation. J Obstet Gynaecol Res. 2020 Jan;46(1):181-185. doi: 10.1111/jog.14131. Epub 2019 Oct 22.

Jiang J, Xue M. The treatment of cervical pregnancy with high-intensity focused ultrasound followed by suction curettage: report of three cases. Int J Hyperthermia. 2019 Jan 24:1-4. doi: 10.1080/02656736.2018.1563914.

Yu L, Xu L, Xu X. Treatment of cornual pregnancy in a patient with adenomyosis by high-intensity focused ultrasound (HIFU) ablation: A case report. Medicine (Baltimore). 2017 Dec;96(48):e8874. doi: 10.1097/MD.0000000000008874.

He GB1, Luo W, Zhou XD, Liu LW, Yu M, Ma XD. A preliminary clinical study on high-intensity focused ultrasound therapy for tubal pregnancy. Scott Med J. 2011 Nov;56(4):214-9.

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Clinical Trials