Nijjar Simrit, Sandhar Simarjit, Timor-Tritsch Ilan E, Agten Andrea Kaelin, Li Jin, Chong Krystle Y, Oza Munira, Acklom Rosanna, D'Antonio Francesco, Vuong Lan N, Mol Ben, Bottomley Cecilia, Jurkovic Davor
EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK.
Hackensack Meridian School of Medicine, Nutley, New Jersey, USA.
BJOG. 2025 Feb;132(3):278-287. doi: 10.1111/1471-0528.17989. Epub 2024 Nov 7.
Caesarean scar ectopic pregnancy (CSEP) is associated with significant maternal and foetal morbidity. However, the optimal treatment remains unknown.
The aim of this study was to review outcomes reported in studies on CSEP treatment and outcome reporting quality.
We reviewed 1270 articles identified through searching PubMed, MEDLINE and Google Scholar from 2014 to 2024 using the search terms 'caesarean scar ectopic pregnancy and caesarean scar pregnancy'.
We included all study types evaluating any form of CSEP treatment, with a sample size of ≥ 50, where diagnosis was described, and the article was in English.
Two authors independently reviewed studies and assessed outcome reporting and methodological quality. The relationship between outcome reporting quality and publication year and journal type was assessed with univariate and bivariate models.
A total of 108 studies, including 17 941 women, were included. 83% of all studies originated from China. Studies reported on 326 outcomes; blood loss (86%), need for additional intervention (77%) and time for serum hCG to normalise post treatment (69%) were the most common outcomes. A primary outcome was clearly defined in 11 (10%) studies. The median quality of outcome reporting was 3 (IQR 3-4). No relationship was demonstrated between outcome reporting quality and publication year (p = 0.116) or journal type (p = 0.503).
This review demonstrates that there is a wide variation in outcomes reported in studies on CSEP treatment. Development and implementation of a core outcome set by international stakeholders which includes patients is urgently needed to enable high-quality research that is both useful and relevant to patients.
剖宫产瘢痕部位异位妊娠（CSEP）与严重的母婴发病率相关。然而，最佳治疗方法仍不明确。
本研究的目的是回顾关于CSEP治疗及结果报告质量的研究中所报道的结果。
我们使用检索词“剖宫产瘢痕部位异位妊娠和剖宫产瘢痕妊娠”，回顾了2014年至2024年期间通过检索PubMed、MEDLINE和谷歌学术搜索到的1270篇文章。
我们纳入了所有评估任何形式CSEP治疗的研究类型，样本量≥50，描述了诊断方法，且文章为英文。
两位作者独立回顾研究并评估结果报告和方法学质量。采用单变量和双变量模型评估结果报告质量与发表年份和期刊类型之间的关系。
共纳入108项研究，涉及17941名女性。所有研究的83%来自中国。研究报告了326项结果；失血（86%）、需要额外干预（77%）和治疗后血清人绒毛膜促性腺激素（hCG）恢复正常的时间（69%）是最常见的结果。11项（10%）研究明确界定了主要结果。结果报告的质量中位数为3（四分位间距3 - 4）。结果报告质量与发表年份（p = 0.116）或期刊类型（p = 0.503）之间未显示出相关性。
本综述表明，关于CSEP治疗的研究中所报告的结果存在很大差异。迫切需要由包括患者在内的国际利益相关者制定并实施一个核心结局集，以开展对患者有用且相关的高质量研究。
