Definition and sonographic reporting system for Cesarean scar pregnancy in early gestation: modified Delphi method

Autor: Davor Jurkovic, C Verberkt, A Kaelin Agten, Tom Bourne, Nicole Jastrow, I. P. M. Jordans, H.A.M. Brölmann, Jaf Huirne, Olga Vikhareva, O. Naji, C. M. Bilardo, Wouter J. K. Hehenkamp, L. F. van der Voet, Margit Dueholm, D. Timmerman, T. Van den Bosch, R. de Leeuw, Eva Pajkrt, Roy Mashiach
Přispěvatelé: Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), Other Research, APH - Quality of Care, APH - Societal Participation & Health, Obstetrics and Gynaecology, APH - Personalized Medicine, ARD - Amsterdam Reproduction and Development
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Technology
medicine.medical_specialty
1ST TRIMESTER
Referral
Delphi method
Computer-assisted web interviewing
cicatrix
ULTRASOUND DIAGNOSIS
Obstetrics and gynaecology
Delphi technique
parasitic diseases
MANAGEMENT
medicine
Humans
PLACENTA-ACCRETA
Radiology
Nuclear Medicine and imaging
Cervix
computer.programming_language
Pregnancy
Science & Technology
Radiological and Ultrasound Technology
Cesarean Section
Obstetrics
business.industry
Radiology
Nuclear Medicine & Medical Imaging
fungi
Obstetrics & Gynecology
Obstetrics and Gynecology
Acoustics
LOWER UTERINE SEGMENT
NATURAL-HISTORY
General Medicine
ultrasonography
Cesarean scar pregnancy
medicine.disease
ECTOPIC PREGNANCY
PRENATAL ULTRASOUND
Pregnancy
Ectopic
medicine.anatomical_structure
Reproductive Medicine
classification
Female
IMPLANTATION
Uterine cavity
pregnancy
business
Life Sciences & Biomedicine
computer
Delphi
Zdroj: Jordans, I P M, Verberkt, C, de Leeuw, R A, Bilardo, C M, van den Bosch, T, Bourne, T, Brölmann, H A M, Dueholm, M, Hehenkamp, W J K, Jastrow, N, Jurkovic, D, Kaelin Agten, A, Mashiach, R, Naji, O, Pajkrt, E, Timmerman, D, Vikhareva, O, van der Voet, L F & Huirne, J A F 2022, ' Definition and sonographic reporting system for Cesarean scar pregnancy in early gestation : modified Delphi method ', Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 59, no. 4, pp. 437-449 . https://doi.org/10.1002/uog.24815
Jordans, I P M, Verberkt, C, De Leeuw, R A, Bilardo, C M, Van Den Bosch, T, Bourne, T, Brölmann, H A M, Dueholm, M, Hehenkamp, W J K, Jastrow, N, Jurkovic, D, Kaelin Agten, A, Mashiach, R, Naji, O, Pajkrt, E, Timmerman, D, Vikhareva, O, Van Der Voet, L F & Huirne, J A F 2022, ' Definition and sonographic reporting system for Cesarean scar pregnancy in early gestation : modified Delphi method ', Ultrasound in Obstetrics and Gynecology, vol. 59, no. 4, pp. 437-449 . https://doi.org/10.1002/uog.24815
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 59(4), 437-449. John Wiley and Sons Ltd
Ultrasound in obstetrics & gynecology, 59(4), 437-449. John Wiley and Sons Ltd
ISSN: 0960-7692
DOI: 10.1002/uog.24815
Popis: OBJECTIVE: To develop a standardized sonographic evaluation and reporting system for Cesarean scar pregnancy (CSP) in the first trimester, for use by both general gynecology and expert clinics. METHODS: A modified Delphi procedure was carried out, in which 28 international experts in obstetric and gynecological ultrasonography were invited to participate. Extensive experience in the use of ultrasound to evaluate Cesarean section (CS) scars in early pregnancy and/or publications concerning CSP or niche evaluation was required to participate. Relevant items for the detection and evaluation of CSP were determined based on the results of a literature search. Consensus was predefined as a level of agreement of at least 70% for each item, and a minimum of three Delphi rounds were planned (two online questionnaires and one group meeting). RESULTS: Sixteen experts participated in the Delphi study and four Delphi rounds were performed. In total, 58 items were determined to be relevant. We differentiated between basic measurements to be performed in general practice and advanced measurements for expert centers or for research purposes. The panel also formulated advice on indications for referral to an expert clinic. Consensus was reached for all 58 items on the definition, terminology, relevant items for evaluation and reporting of CSP. It was recommended that the first CS scar evaluation to determine the location of the pregnancy should be performed at 6-7 weeks' gestation using transvaginal ultrasound. The use of magnetic resonance imaging was not considered to add value in the diagnosis of CSP. A CSP was defined as a pregnancy with implantation in, or in close contact with, the niche. The experts agreed that a CSP can occur only when a niche is present and not in relation to a healed CS scar. Relevant sonographic items to record included gestational sac (GS) size, vascularity, location in relation to the uterine vessels, thickness of the residual myometrium and location of the pregnancy in relation to the uterine cavity and serosa. According to its location, a CSP can be classified as: (1) CSP in which the largest part of the GS protrudes towards the uterine cavity; (2) CSP in which the largest part of the GS is embedded in the myometrium but does not cross the serosal contour; and (3) CSP in which the GS is partially located beyond the outer contour of the cervix or uterus. The type of CSP may change with advancing gestation. Future studies are needed to validate this reporting system and the value of the different CSP types. CONCLUSION: Consensus was achieved among experts regarding the sonographic evaluation and reporting of CSP in the first trimester. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. ispartof: ULTRASOUND IN OBSTETRICS & GYNECOLOGY vol:59 issue:4 pages:437-449 ispartof: location:England status: published
Databáze: OpenAIRE
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