{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:04:01Z","timestamp":1792062241575,"version":"4.4.0"},"reference-count":11,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"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":[[2020,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Caesarean scar ectopic pregnancy (CSP) is defined as blastocyst implantation occurring in a uterine scar. The incidence of CSP continues to rise with increasing caesarean section rates; prevalence is estimated to be 1:1800 to 1:2226 of all pregnancies. To date, over 30 treatment regimens have been published. The Royal College of Obstetricians and Gynaecologists guidelines (2016) state there is insufficient evidence to support one specific intervention over another.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To review outcomes of medical and surgical management of CSP cases at a single tertiary centre over a nine\u2010year period, in order to establish the safest and most effective management approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>An audit was undertaken of patients treated for CSP between January 2009 and March 2017 at King Edward Memorial Hospital, Western Australia. Patient demographic and treatment outcome data were extracted from medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010one patients were identified as having CSP diagnosed during this time period, of which five were excluded due to lack of data, leaving a total of 46 cases. The majority of patients (52%, <jats:italic>n<\/jats:italic>\u00a0=\u00a024) elected for initial surgical management, while 41% (<jats:italic>n<\/jats:italic>\u00a0=\u00a019) trialled medical management. Seven percent (<jats:italic>n<\/jats:italic>\u00a0=\u00a03) opted for conservative management. Success rates of surgical, medical and conservative management were 100%, 53% and 0% respectively (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Medical management was associated with prolonged follow\u2010up; there was no difference in complication rates between surgical and medical managements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this audit, surgical management was the most effective way to manage CSP. There was no significant difference in complication rates between the two groups.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13241","type":"journal-article","created":{"date-parts":[[2020,8,21]],"date-time":"2020-08-21T04:20:38Z","timestamp":1597983638000},"page":"852-857","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Caesarean scar ectopic pregnancy: Evolution from medical to surgical management"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3199-2650","authenticated-orcid":false,"given":"Caitlin","family":"Roche","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"McDonnell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kym","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy","family":"Milward","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette","family":"McElhinney","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chhaya","family":"Mehrotra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayiotis","family":"Maouris","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology King Edward Memorial Hospital Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.974"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.01237.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.56"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2009.01067.x"},{"key":"e_1_2_6_6_1","volume-title":"Australia\u2019s Mothers and Babies 2015 \u2010 In Brief [Internet]","author":"Australian Institute of Health and Welfare","year":"2017"},{"key":"e_1_2_6_7_1","volume-title":"National Maternity Services Plan [Internet]","author":"Australian Government Department of Health","year":"2011"},{"key":"e_1_2_6_8_1","volume-title":"Diagnosis and Management of Ectopic Pregnancy; Green\u2010top Guideline No. 21 [Internet]","author":"Royal College of Obstetricians and Gynaecologists","year":"2016"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.12.130"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4058"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.05.019"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15255"}],"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.13241","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13241","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T17:26:02Z","timestamp":1693761962000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,20]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/ajo.13241"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13241","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,20]]},"assertion":[{"value":"2019-12-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}