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. Tweetable abstract Surgery for CSP appears to be successful, with low complication rates and short post‐treatment follow up.

Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-CoV-2 infection in the UK: a national cohort study using the UK Obstetric Surveillance System (UKOSS)

“…It should be noted, however, that higher hospitalisation rates in the third trimester were also reported in the context of influenza, 31 and thought to be for precautionary reasons, rather than necessarily because of maternal compromise. Although case notification has been augmented through a link with the UK Early Pregnancy Surveillance System (UKEPSS), 32 it is also possible that the route of identification of the cases included in this series, through UK obstetric units, has led to under-ascertainment of women admitted in the early stages of pregnancy.…”

Author's reply re: Caesarean scar pregnancy in the UK: a national cohort study

“…We thank Pandey and Tyagi for their comments in response to our article . We agree that there is a need to further our understanding regarding the underlying risk factors for caesarean scar pregnancy (CSP).…”

Re: Caesarean scar pregnancy in the UK: a national cohort study

“…We would like to add that the elegantly conceptualised article by Harb et al 1 , assessing the clinical outcomes and stringent management of caesarean scar pregnancies (CSP) in a well-defined patient population subset in the UK, is informative. Pregnancyrelated complications and clinical management protocols are indeed essential to cost-effectively reduce the morbidity and mortality associated with reproductive disorders, including miscarriages, CSP and infertility.…”

“…We would like to add that the elegantly conceptualised article by Harb et al ,. assessing the clinical outcomes and stringent management of caesarean scar pregnancies (CSP) in a well‐defined patient population subset in the UK, is informative.…”