{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T10:38:57Z","timestamp":1793529537872,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,4,6]],"date-time":"2016-04-06T00:00:00Z","timestamp":1459900800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2016,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To assess the efficacy of ultrasound\u2010guided suction curettage for management of pregnancies implanted into the lower uterine segment Cesarean section scar.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a retrospective study including women diagnosed with Cesarean section scar pregnancy at two large tertiary referral early pregnancy units between 1997 and 2014. Surgical evacuation was offered to selected women presenting in the first trimester \u2264 14 weeks' gestation. All procedures were performed transcervically under ultrasound guidance using suction curettage. A modified Shirodkar cervical suture was used in women who required additional measures to secure hemostasis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 232 women with Cesarean section scar pregnancy were seen at the referral units; 191\/232 (82.3%) women were treated surgically. The median intraoperative blood loss was 100\n mL<\/jats:styled-content>\n (range, 10\u20133000\n mL<\/jats:styled-content>\n ); 9\/191 (4.7% (95%\n CI<\/jats:styled-content>\n , 1.7\u20137.7%)) women required blood transfusion and, in one (0.5% (95%\n CI<\/jats:styled-content>\n , 0\u20131.5%)), life\u2010saving hysterectomy had to be performed because of uncontrollable intraoperative bleeding. Of the women who attended for follow\u2010up, 7\/116 (6.0% (95%\n CI<\/jats:styled-content>\n , 1.7\u201310.3%)) required a repeat surgical procedure because of retained products of conception. Multivariable analysis showed that the gestational sac diameter (odds ratio (\n OR<\/jats:styled-content>\n ), 1.10 (95%\n CI<\/jats:styled-content>\n , 1.03\u20131.17)) and pregnancy vascularity on Doppler examination (\n OR<\/jats:styled-content>\n , 3.41 (95%\n CI<\/jats:styled-content>\n , 1.39\u20138.33)) were significant predictors of heavy intraoperative blood loss (> 1000\n mL<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Ultrasound\u2010guided suction curettage is an effective method for the treatment of pregnancies implanted into a lower uterine segment Cesarean section scar and is associated with a low risk of blood transfusion and hysterectomy. Copyright \u00a9 2016 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.15857","type":"journal-article","created":{"date-parts":[[2016,1,14]],"date-time":"2016-01-14T09:44:06Z","timestamp":1452764646000},"page":"511-517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":134,"title":["Surgical treatment of Cesarean scar ectopic pregnancy: efficacy and safety of ultrasound\u2010guided suction curettage"],"prefix":"10.1002","volume":"47","author":[{"given":"D.","family":"Jurkovic","sequence":"first","affiliation":[{"name":"Institute of Women's Health University College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Knez","sequence":"additional","affiliation":[{"name":"Institute of Women's Health University College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Appiah","sequence":"additional","affiliation":[{"name":"Early Pregnancy Unit, King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Farahani","sequence":"additional","affiliation":[{"name":"Early Pregnancy Unit, King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Mavrelos","sequence":"additional","affiliation":[{"name":"Institute of Women's Health University College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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