| Autor: |
Fourie H; John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, UK., El-Zibdeh A; John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, UK., Heppell V; Early Pregnancy Assessment Unit, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK., Granne I; Nuffield Department of Women's and Reproductive Health, Oxford University, Oxford OX1 2JD, UK., Lim LN; John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, UK., Supramaniam PR; John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, UK.; Nuffield Department of Women's and Reproductive Health, Oxford University, Oxford OX1 2JD, UK. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of clinical medicine [J Clin Med] 2022 Nov 29; Vol. 11 (23). Date of Electronic Publication: 2022 Nov 29. |
| DOI: |
10.3390/jcm11237063 |
| Abstrakt: |
Caesarean Scar Pregnancy (CSP) is an ectopic pregnancy with implantation into the niche of the uterine scar. We aimed to describe the local management of consecutive cases of CSP to develop a standard operating procedure (SOP). Between December 2019 and June 2022, there were 19,100 maternities. Of these, 23 were CSPs in 19 patients. Median BMI was 29 (range 20.5-52), median number of Caesarean deliveries (CS) was 2 (range 1-4) and 7/23 (30%) were cigarette smokers. At diagnosis, 9/23 were live pregnancies, 3/23 were retained products of conception (RPOC), 9/23 were pregnancies of uncertain viability (PUV), and 2/23 were non-viable. In six, the initial management was expectant, surgical suction evacuation with transrectal ultrasound guidance in 16, and one had a hysterectomy. The median blood loss was 100 mL (range 50-2000 mL). Two patients (9%) required a blood transfusion. Median hospital stay was 1 day (range 0-4). At follow-up after 10 weeks, no patients had an ongoing haematoma, and one had significant RPOC electing hysterectomy. Eight women were known to have 9 subsequent pregnancies (recurrent CSP n = 4, livebirth n = 2, miscarriage n = 2, tubal ectopic n = 1). Outcomes as rated by low blood loss, short hospital stay, and rare need for further intervention were favorable. Factors associated included prompt ultrasonographic diagnosis, availability of transrectal ultrasound guided surgery, and specialist follow-up, which form the basis of the SOP. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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