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Scoring system for the prediction of the successful treatment modality in women with cesarean scar pregnancy
Author(s) -
Sun QiuLei,
Luo Li,
Gao ChunYan,
Yan Ping,
Yang Ying,
Chen ZhengQiong
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12881
Subject(s) - medicine , gestational sac , uterine artery embolization , uterine artery , pregnancy , surgery , embolization , obstetrics , gestational age , gestation , genetics , biology
Objective To establish a risk scoring system to predict the successful treatment of cesarean scar pregnancy. Methods A prospective observational study was conducted between June 2016 and March 2018 in a tertiary care center. Patients received evacuation followed by uterine artery embolization and laparoscopic local resection/hysterectomy successively as salvage measures if necessary. Optimal scaling regression determined the extent of each potential prognostic factor predicted. Results Out of 228 women, 144 cases required evacuation before recovery, 73 women required uterine artery embolization, and 11 women eventually required laparoscopic surgery. Six variables were included in the predictive model: number of cesarean deliveries; maximal diameter of gestational sac; remnant myometrial thickness; grading of Doppler signals; presence of fetal heartbeat; and location of gestational sac. A 10‐point scoring system was established by weighting their prediction of the method of successful treatment. In the risk score rank of 1–4, only 4 (2.8%) out of 142 women needed uterine artery embolization as a salvage treatment, while in the risk score rank of 8–10, 41 (80.4%) cases needed uterine artery embolization; laparoscopic operations were performed by physicians for the other 10 (19.6%) cases. Conclusion The successful treatment of cesarean scar pregnancy was accurately predicted by a 10‐point scoring system. Chinese Clinical Trials Registry ChiCTR‐OOC‐16008467.