Definition and sonographic reporting system for Cesarean scar pregnancy in early gestation: modified Delphi method.
Definition and sonographic reporting system for Cesarean scar pregnancy in early gestation: modified Delphi method.
复制标题
DOI：
10.1002/uog.24815
复制
发表时间：
2022-04
影响因子：
7.1
通讯作者：
Huirne, J. A. F.
中科院分区：
文献类型：
--
作者：
Jordans, I. P. M.;Verberkt, C.;De Leeuw, R. A.;Bilardo, C. M.;Van den Bosch, T.;Bourne, T.;Brolmann, H. A. M.;Dueholm, M.;Hehenkamp, W. J. K.;Jastrow, N.;Jurkovic, D.;Agten, A. Kaelin;Mashiach, R.;Naji, O.;Pajkrt, E.;Timmerman, D.;Vikhareva, O.;Van der Voet, L. F.;Huirne, J. A. F.
建立一个标准化的超声评价和报告系统，用于早期妊娠的剖宫产瘢痕妊娠（CSP），供普通妇科和专家门诊使用。采用改良的德尔菲法，邀请了28名妇产科超声检查领域的国际专家参与。需要在使用超声评价妊娠早期剖宫产（CS）瘢痕方面有丰富经验和/或关于CSP或利基评价的出版物。根据文献检索结果确定CSP检测和评价的相关项目。共识被预先定义为每个项目至少70%的一致性水平，计划至少三轮德尔菲（两次在线问卷调查和一次小组会议）。十六位专家参加了德尔菲研究，并进行了四轮德尔菲。总共有58个项目被确定为相关。我们区分了在一般实践中进行的基本测量和专家中心或研究目的的高级测量。该小组还就转诊到专家诊所的指征提出了建议。就CSP的定义、术语、评价和报告的相关项目的所有58个项目达成了共识。建议在妊娠6-7周时使用经阴道超声进行首次CS瘢痕评估以确定妊娠位置。磁共振成像的使用不被认为是增加价值的CSP的诊断。CSP被定义为在龛位中植入或与龛位密切接触的妊娠。专家们一致认为，CSP只能发生在一个利基存在，而不是在一个愈合的CS疤痕。记录的相关超声项目包括妊娠囊（GS）大小、血管分布、与子宫血管的关系、残留子宫肌层厚度以及妊娠与子宫腔和浆膜的关系。根据其位置，CSP可分为：（1）CSP，其中GS的最大部分向子宫腔突出;（2）CSP，其中GS的最大部分嵌入子宫肌层但不穿过浆膜轮廓;和（3）CSP，其中GS部分位于宫颈或子宫的外轮廓之外。CSP的类型可随妊娠的进展而改变。未来的研究需要验证这一报告系统和不同CSP类型的价值。专家们就妊娠早期CSP的超声评价和报告达成了共识。版权所有© 2021作者。妇产科超声由John Wiley & Sons Ltd代表国际妇产科超声学会出版。本文摘要已被翻译成西班牙语和中文。按照摘要中的链接查看翻译。
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. 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). 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. 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. This article's abstract has been translated into Spanish and Chinese. Follow the links from the abstract to view the translations.
登录
查看更多内容
影响因子：
3.8
作者：
Hasson, F;Keeney, S;McKenna, H
通讯作者：
McKenna, H
影响因子：
7.1
作者：
Abdallah, Y.;Daemen, A.;Bourne, T.
通讯作者：
Bourne, T.
影响因子：
7.1
作者：
Jurkovic, D.;Knez, J.;Ross, J. A.
通讯作者：
Ross, J. A.
影响因子：
7.1
作者：
Cali, G.;Forlani, F.;D'Antonio, F.
通讯作者：
D'Antonio, F.
影响因子：
1.8
作者：
Dubuisson, Jean-Bernard;Ben Ali, Nordine;Feki, Anis
通讯作者：
Feki, Anis