{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T14:44:44Z","timestamp":1776177884999,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T00:00:00Z","timestamp":1579046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite the rising incidence of caesarean scar pregnancy (CSP), as yet there are no consensus or evidence\u2010based guidelines for management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To review diagnosis, treatment and management of all women with CSP over a 5\u00a0year period at Mater Mothers\u2019 Hospital, Brisbane, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Retrospective cohort study of CSP between 2013\u20132018. Data reviewed included demographics, presenting symptoms, gestational age, ultrasound findings, human chorionic gonadotrophin levels, treatment success, complications, and if available, subsequent pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010eight women were treated for CSP during the study period. Initial diagnosis was delayed in ten (36%). Overall success rates of initial treatment were 22\/28 (79%). Of the six cases of failed treatment, five had been treated with systemic methotrexate alone. All women requiring further intervention had fetal pole present, and 50% had fetal cardiac activity. Failure rate of systemic methotrexate alone was 5\/11 (45%). Eleven women deemed appropriate for conservative management did not require further treatment or experience complications. Nine women had data available for subsequent pregnancies, of whom two developed placenta accreta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides data that may assist in guideline development and decision\u2010making for management of CSP. Conservative management in carefully selected women appeared to be safe. Nearly half of women treated with systemic methotrexate alone required another treatment modality, suggesting a role for intralesional treatment, particularly in the presence of fetal pole \u00b1 fetal cardiac activity. More than one in five women with documented subsequent pregnancies were diagnosed with placenta accreta.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13119","type":"journal-article","created":{"date-parts":[[2020,1,16]],"date-time":"2020-01-16T02:03:29Z","timestamp":1579140209000},"page":"330-335","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Caesarean scar ectopic pregnancy: Experience from an Australian tertiary centre"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-8769","authenticated-orcid":false,"given":"Natalie","family":"Drever","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Mater Mothers\u2019 Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Bertolone","sequence":"additional","affiliation":[{"name":"Early Pregnancy Assessment Unit Mater Mother\u2019s Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan","family":"Shawki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Mater Mothers\u2019 Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Janssens","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Mater Mothers\u2019 Hospital Brisbane Queensland Australia"},{"name":"Mater Education Mater Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,15]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.56"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.974"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2014.954101"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15857"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000023"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12273"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2018.1451986"},{"key":"e_1_2_5_9_1","unstructured":"Queensland Clinical Guidelines.Pregnancy Loss. Guideline number MN17.29\u2010V5\u2010R22. Queensland Health.2017. Available from URL:http:\/\/www.health.qld.gov.au\/qcg."},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(02)00018-8"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2205-0140.2015.tb00222.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmh042"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2009.01067.x"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e3280105886"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-011-0097-y"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb11547.x"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14189"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13282"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13119","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13119","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13119","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T02:31:43Z","timestamp":1693967503000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,15]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1111\/ajo.13119"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13119","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,15]]},"assertion":[{"value":"2019-09-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}