{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:35:40Z","timestamp":1777944940862,"version":"3.51.4"},"reference-count":79,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003243","name":"Ministerstvo Zdravotnictv\u00ed Cesk\u00e9 Republiky","doi-asserted-by":"publisher","award":["NW24-09-00505"],"award-info":[{"award-number":["NW24-09-00505"]}],"id":[{"id":"10.13039\/501100003243","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007397","name":"Univerzita Karlova v Praze","doi-asserted-by":"publisher","award":["Cooperatio program, Maternal and Childhood Care No"],"award-info":[{"award-number":["Cooperatio program, Maternal and Childhood Care No"]}],"id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ectopic pregnancy (EP) remains a significant cause of maternal morbidity and mortality, with diverse clinical presentations and substantial variability in treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess current EP management approaches across gynecological inpatient departments of all sizes in the Czech Republic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A nationwide cross-sectional observational questionnaire study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A survey was conducted in January 2025. All 92 registered inpatient gynecological wards in the Czech Republic were invited to participate in an anonymous online questionnaire on EP diagnosis and treatment. A total of 89 departments (96.7%) responded. Facilities were grouped into four categories based on annual hysterectomy volume. Statistical analyses included chi-squared and Fisher\u2019s exact tests with adjustments for multiple comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Methotrexate (MTX) was available in 82.8% of high-volume centers, compared with 48.3% of smaller facilities (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002). Despite this, 46.1% of institutions reported never using MTX. The use of MTX for all types of EP was significantly more common in larger centers (72.4% versus 45.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.023), although its use for tubal EP remained generally low (18.0%) with no significant difference by center size. Surgical treatment of tubal EP was consistently preferred by 36.0% of facilities, and 38.2% of surgeons occasionally performed salpingotomy. Laparoscopy was the dominant approach for interstitial pregnancies (86.5%), with universal adoption in high-volume centers (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.007). Suction and curettage were most commonly used for cesarean scar (47.2%) and cervical (60.7%) pregnancies, although treatment strategies varied considerably. Observational management was preferred in pregnancy of unknown location with declining human chorionic gonadotropin (hCG) levels (83.2%), while diagnostic laparoscopy was favored when hCG levels plateaued or rose (57.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>EP management, even within a country with a homogeneous healthcare system, may demonstrate considerable heterogeneity, strongly influenced by institutional size. These findings highlight the need for national guidelines to ensure standardized and evidence-based care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057261435815","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T10:27:32Z","timestamp":1776508052000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ectopic pregnancy management and treatment strategies: A nationwide survey of Czech gynecological facilities"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2622-2181","authenticated-orcid":false,"given":"Borek","family":"Sehnal","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Zapletal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6055-2569","authenticated-orcid":false,"given":"Michael J.","family":"Halaska","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0433-5477","authenticated-orcid":false,"given":"Krystof","family":"Brecka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6209-0533","authenticated-orcid":false,"given":"Barbora","family":"Svedova","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Hruda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9268-6957","authenticated-orcid":false,"given":"Anna","family":"Babkova","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3770-651X","authenticated-orcid":false,"given":"Lukas","family":"Rob","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petr","family":"Waldauf","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Medicine, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"19","article-title":"Overview of ectopic pregnancy diagnosis, management, and innovation","author":"Mullany K","year":"2023","unstructured":"Mullany K, Minneci M, Monjazeb R, et al. 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