Caesarean scar pregnancy in the uk: a national cohort study

H M Harb; M Knight; C Bottomley; C Overton; A Tobias; I D Gallos; Manjeet Shehmar; R Farquharson; A Horne; P Latthe; E Edi-Osagie; M MacLean; E Marston; J Zamora; F Dawood; R Small; J Ross; T Bourne; A Coomarasamy; D Jurkovic

doi:10.1111/1471-0528.15255

Caesarean scar pregnancy in the uk: a national cohort study

H M Harb
, M Knight
, C Bottomley
, C Overton
, A Tobias
, I D Gallos
, Manjeet Shehmar
, R Farquharson
, A Horne
, P Latthe
, E Edi-Osagie
, M MacLean
, E Marston
, J Zamora
, F Dawood
, R Small
, J Ross
, T Bourne
, A Coomarasamy
, D Jurkovic

School of Regeneration and Repair

Research output: Contribution to journal › Article › peer-review

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. This article is protected by copyright. All rights reserved.

Original language	English
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Early online date	26 Apr 2018
DOIs	https://doi.org/10.1111/1471-0528.15255
Publication status	E-pub ahead of print - 26 Apr 2018

Keywords / Materials (for Non-textual outputs)

Journal Article

Access to Document

10.1111/1471-0528.15255

Cite this

Harb, H. M., Knight, M., Bottomley, C., Overton, C., Tobias, A., Gallos, I. D., 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. (2018). Caesarean scar pregnancy in the uk: a national cohort study. BJOG: An International Journal of Obstetrics and Gynaecology. Advance online publication. https://doi.org/10.1111/1471-0528.15255

@article{90e94650dbdb46c28ae5001e1630fbbb,

title = "Caesarean scar pregnancy in the uk: a national cohort study",

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. This article is protected by copyright. All rights reserved.",

keywords = "Journal Article",

author = "Harb, \{H M\} and M Knight and C Bottomley and C Overton and A Tobias and Gallos, \{I D\} and Manjeet Shehmar and R Farquharson and A Horne and P Latthe and E Edi-Osagie and M MacLean and E Marston and J Zamora and F Dawood and R Small and J Ross and T Bourne and A Coomarasamy and D Jurkovic",

year = "2018",

month = apr,

day = "26",

doi = "10.1111/1471-0528.15255",

language = "English",

journal = "BJOG: An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "Wiley",

}

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 2018, 'Caesarean scar pregnancy in the uk: a national cohort study', BJOG: An International Journal of Obstetrics and Gynaecology. https://doi.org/10.1111/1471-0528.15255

TY - JOUR

T1 - Caesarean scar pregnancy in the uk

T2 - a national cohort study

AU - Harb, H M

AU - Knight, M

AU - Bottomley, C

AU - Overton, C

AU - Tobias, A

AU - Gallos, I D

AU - Shehmar, Manjeet

AU - Farquharson, R

AU - Horne, A

AU - Latthe, P

AU - Edi-Osagie, E

AU - MacLean, M

AU - Marston, E

AU - Zamora, J

AU - Dawood, F

AU - Small, R

AU - Ross, J

AU - Bourne, T

AU - Coomarasamy, A

AU - Jurkovic, D

PY - 2018/4/26

Y1 - 2018/4/26

N2 - 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. This article is protected by copyright. All rights reserved.

AB - 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. This article is protected by copyright. All rights reserved.

KW - Journal Article

U2 - 10.1111/1471-0528.15255

DO - 10.1111/1471-0528.15255

M3 - Article

C2 - 29697890

SN - 1470-0328

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

ER -

Caesarean scar pregnancy in the uk: a national cohort study

Abstract

Keywords / Materials (for Non-textual outputs)

Access to Document

Fingerprint

Cite this