[Vaginal impingement of uterine arteries (Zea technique) prior to cervical curettage in cervical ectopic pregnancy: three case report and literature review]

Abstract

Cervical ectopic pregnancy is a rare and danger clinical presentation because it has high risk of massive bleeding. The incidence is reported in 1:2500 pregnancies and has high relation with a history of cervical dilatation and curettage and assisted reproductive techniques. Advances in ultrasound resolution and use of beta fraction of human chorionic gonadotropin allow early diagnosis and provide conservative treatment with decreased morbidity, mortality and fertility preservation. Various techniques have been reported associated with cervical curettage, to reduce bleeding at the implantation site. In this report three cases of cervical ectopic pregnancy managed with cervical curettage, prior vaginal impingement of uterine arteries (Zea Technique) at the Instituto Nacional de Perinatología Isidro Espinosa de los Reyes are described. The Zea technique represents an effective option in the control of obstetric hemorrhage, including patients diagnosed with cervical ectopic pregnancy in who the bleeding volume decrease after its placement. The Zea Technique is easy to apply and preserves fertility. The success of combining this technique with endocervical curettage for the management of cervical ectopic pregnancy is demonstrated. Training for performing this technique does not require highly specialized or highly complex resources since the required material is the usual every area of obstetric care.