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Definition and sono...
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Jordans, I. P.M.
(author)
Definition and sonographic reporting system for Cesarean scar pregnancy in early gestation : modified Delphi method
- Article/chapterEnglish2022
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LIBRIS-ID:oai:lup.lub.lu.se:016de5a0-14e6-41c5-a654-65ccd4879db2
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https://lup.lub.lu.se/record/016de5a0-14e6-41c5-a654-65ccd4879db2URI
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https://doi.org/10.1002/uog.24815DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
Notes
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Objective: 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. Methods: 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). Results: 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. Conclusion: Consensus was achieved among experts regarding the sonographic evaluation and reporting of CSP in the first trimester.
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Verberkt, C.
(author)
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De Leeuw, R. A.Academic Medical Center of University of Amsterdam (AMC)
(author)
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Bilardo, C. M.
(author)
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Van Den Bosch, T.University Hospitals Leuven,Catholic University of Leuven
(author)
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Bourne, T.Imperial College London
(author)
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Brölmann, H. A.M.
(author)
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Dueholm, M.Aarhus University Hospital
(author)
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Hehenkamp, W. J.K.Academic Medical Center of University of Amsterdam (AMC)
(author)
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Jastrow, N.Geneva University Hospital
(author)
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Jurkovic, D.University College London Hospital
(author)
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Kaelin Agten, A.Queen's Medical Centre, Nottingham
(author)
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Mashiach, R.Tel-Aviv University,Sheba Medical Center
(author)
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Naji, O.Imperial College London
(author)
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Pajkrt, E.Academic Medical Center of University of Amsterdam (AMC)
(author)
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Timmerman, D.University Hospitals Leuven
(author)
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Vikhareva, O.Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-oav
(author)
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Van Der Voet, L. F.Deventer Hospitals
(author)
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Huirne, J. A.F.Academic Medical Center of University of Amsterdam (AMC)
(author)
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Academic Medical Center of University of Amsterdam (AMC)University Hospitals Leuven
(creator_code:org_t)
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In:Ultrasound in Obstetrics and Gynecology: Wiley59:4, s. 437-4490960-76921469-0705
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Jordans, I. P.M.
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Verberkt, C.
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De Leeuw, R. A.
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Bilardo, C. M.
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Van Den Bosch, T ...
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Bourne, T.
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Brölmann, H. A.M ...
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Dueholm, M.
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Hehenkamp, W. J. ...
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Jastrow, N.
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Jurkovic, D.
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Kaelin Agten, A.
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Mashiach, R.
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Naji, O.
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Pajkrt, E.
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Timmerman, D.
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Vikhareva, O.
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Van Der Voet, L. ...
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Huirne, J. A.F.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Obstetrics Gynae ...
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MEDICAL AND HEAL ...
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Ultrasound in Ob ...
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Lund University