|
3
|
Harb HM, Knight M, Bottomley C, Overton C, Tobias A, Gallos ID, Shehmar M, Farquharson R, Horne A, Latthe P, Edi-Osagie E, MacLean M, Marston E, Zamora J, Dawood F, Small R, Ross J, Bourne T, Coomarasamy A, Jurkovic D. Caesarean scar pregnancy in the UK: a national cohort study. BJOG 2018; 125:1663-1670. [PMID: 29697890 DOI: 10.1111/1471-0528.15255] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To estimate the incidence of caesarean scar pregnancy (CSP) and to describe the management outcomes associated with this condition. DESIGN A national cohort study using the UK Early Pregnancy Surveillance Service (UKEPSS). SETTING 86 participating Early Pregnancy Units. POPULATION All women diagnosed in the participating units with CSP between November 2013 and January 2015. METHODS Cohort study of women identified through the UKEPSS monthly mailing system. MAIN OUTCOME MEASURES Incidence, clinical outcomes and complications. RESULTS 102 cases of CSP were reported, with an estimated incidence of 1.5 per 10 000 (95% CI 1.1-1.9) maternities. Full outcome data were available for 92 women. Management was expectant in 21/92 (23%), medical in 15/92 (16%) and surgical in 56/92 (61%). The success rates of expectant, medical and surgical management were 43% (9/21), 46% (7/15) and 96% (54/56), respectively. The complication rates were 15/21 (71%) with expectant, 9/15 (60%) with medical and 20/56 (36%) with surgical management. Discharge from care (median number of days) was 82 (range 37-174) with expectant, 21 (range 10-31) with medical and 11 (range 4-49) with surgical management. CONCLUSIONS Surgical management appears to be associated with a high success rate, low complication rate and short post-treatment follow up. TWEETABLE ABSTRACT Surgery for CSP appears to be successful, with low complication rates and short post-treatment follow up.
Collapse
Affiliation(s)
- H M Harb
- Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - M Knight
- National Perinatal Epidemiology Unit, Oxford, UK
| | - C Bottomley
- Chelsea and Westminster Hospital, London, UK
| | | | - A Tobias
- Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - I D Gallos
- Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - M Shehmar
- Birmingham Women's Hospital, Edgbaston, UK
| | | | - A Horne
- The Queen's Medical Research Institute, University of Edinburgh and Royal Infirmary of Edinburgh, Edinburgh, UK
| | - P Latthe
- Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - E Edi-Osagie
- Central Manchester University Hospitals, Saint Mary's Hospital, Manchester, UK
| | - M MacLean
- NHS Ayrshire and Arran, Crosshouse Hospital, Kilmarnock, Ayrshire, UK
| | - E Marston
- College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
| | - J Zamora
- Hospital Ramon y Cajal, Madrid, Spain
| | - F Dawood
- Liverpool Women's Hospital, Liverpool, UK
| | - R Small
- Heart of England NHS Foundation Trust, Heartlands Hospital, Bordesley Green East, UK
| | - J Ross
- King's College Hospital, London, UK
| | - T Bourne
- Tommy's National Centre for Miscarriage, Research, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK
| | - A Coomarasamy
- Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | | |
Collapse
|
|
4
|
Ma K, Sentance J, Majumder K, Edi-Osagie E. Laparoscopic Hypogastric Plexus Block - Retrospective Pilot Study of a Novel Local Anaesthetic Technique in Patients Undergoing Laparoscopic Radical Resection of Rectovaginal Endometriosis. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
|
5
|
Sentance J, Ma KYK, Majumder K, Szabo K, Edi-Osagie E. Lower Limb Compartment Syndrome Associated with Laparoscopic Surgery: What a Gynaecologist Needs to Know. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
|
9
|
Tang AW, Alfirevic Z, Turner MA, Drury J, Topping J, Dawood F, Farquharson R, Quenby S, Adam K, Entwisle M, O'Toole K, Bhima G, Palep-Singh M, Edi-Osagie E, Abediasl Z, Moini M, Jansen E, Stoop D, Ermini B, Haentjens P, De Vos M, Polyzos N, Verheyen G, Devroey P, Cabar FR, P. Pereira P, Francisco RP, Zugaib M, Horiuchi R, Miyaji S, Haruki A, Fukuda A, Morimoto Y. SELECTED ORAL COMMUNICATION SESSION, SESSION 34: EARLY PREGNANCY LOSS PROGNOSIS AND TREATMENT, Tuesday 5 July 2011 10:00 - 11:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|