Caesarean scar pregnancy in the UK: a national cohort study
Caesarean scar pregnancy in the UK: a national cohort study
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DOI：
10.1111/1471-0528.15255
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发表时间：
2018-12-01
影响因子：
5.8
通讯作者：
Jurkovic, D.
中科院分区：
文献类型：
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作者：
Harb, H. M.;Knight, M.;Jurkovic, D.
目的探讨剖宫产术后瘢痕妊娠（CSP）的发生率及治疗效果。一项使用英国早期妊娠监测服务（UKEPSS）的国家队列研究。设置人群86参与早孕单位。2013年11月至2015年1月期间在参与单位诊断为CSP的所有女性。方法主要观察指标通过UKEPSS每月邮寄系统确定的妇女队列研究。发病率、临床结局和并发症。结果102例CSP的发生率为1.5/万（95%CI1.1 -1.9）。有92名妇女的完整结局数据可用。21/92例（23%）采用期待治疗，15/92例（16%）采用内科治疗，56/92例（61%）采用外科治疗。保守治疗、内科治疗和外科治疗的成功率分别为43%（9/21）、46%（7/15）和96%（54/56）。并发症发生率：保守治疗组15/21（71%），内科治疗组9/15（60%），外科治疗组20/56（36%）。出院（中位天数）：期待治疗82天（范围37-174天），内科治疗21天（范围10-31天），外科治疗11天（范围4-49天）。手术治疗成功率高，并发症发生率低，治疗后随访时间短。
Objective Design To estimate the incidence of caesarean scar pregnancy (CSP) and to describe the management outcomes associated with this condition. A national cohort study using the UK Early Pregnancy Surveillance Service (UKEPSS). Setting Population 86 participating Early Pregnancy Units. All women diagnosed in the participating units with CSP between November 2013 and January 2015. Methods Main outcome measures Cohort study of women identified through the UKEPSS monthly mailing system. Incidence, clinical outcomes and complications. Results Conclusions 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. Surgical management appears to be associated with a high success rate, low complication rate and short post-treatment follow up.