{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T22:56:40Z","timestamp":1774479400021,"version":"3.50.1"},"reference-count":26,"publisher":"Walter de Gruyter GmbH","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2017-0189_s_999\">\n                  <jats:title>Aim:<\/jats:title>\n                  <jats:p>The purpose of this review is to systematically review all the reported cases and case series of caesarean scar pregnancy (CSP) managed expectantly without any intervention in order to understand the outcomes of pregnancy which will guide clinicians and patients in making treatment choices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0189_s_998\">\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>An electronic search on PubMed, EMBASE and Cochrane databases and a manual search from references of the articles were performed. Studies were selected based on inclusion and exclusion criteria. Data were extracted for various outcomes of pregnancy and the quality of the reports was assessed using a modified Delphi technique.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0189_s_997\">\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>A total of 56 cases of CSP from 11 reports were included in the review, including 44 cases with foetal cardiac activity. Live births were achieved in 73% of cases with a quarter of them born before 34 weeks. Hysterectomy rates were 70%. In 12\/44 (27%) of cases pregnancies were lost due to complications before 24 weeks. Most (67%) of the CSPs with no foetal cardiac activities resolved on expectant management and the remaining required intervention for bleeding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2017-0189_s_996\">\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>Caution should be exercised when choosing expectant management in cases of viable CSPs, and if chosen, the patient should be counselled adequately for possible outcomes including loss of pregnancy and hysterectomy. Expectant management is acceptable in CSPs with no foetal cardiac activity. There is a need for prospective research on this topic with adequate reporting on possible prognostic markers, as well as a need to improve on the techniques to prevent loss of fertility during delivery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2017-0189","type":"journal-article","created":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T22:16:26Z","timestamp":1510179386000},"page":"365-372","source":"Crossref","is-referenced-by-count":41,"title":["Expectant management of caesarean scar ectopic pregnancy: a systematic review"],"prefix":"10.1515","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8257-3771","authenticated-orcid":false,"given":"Pradeep","family":"Jayaram","sequence":"first","affiliation":[{"name":"Obstetrician and Gynaecologist , Sidra Medical and Research Centre, Weill Cornell Medical College-Qatar , Doha , Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gbemisola","family":"Okunoye","sequence":"additional","affiliation":[{"name":"Obstetrician and Gynaecologist , Sidra Medical and Research Centre, Weill Cornell Medical College-Qatar , Doha , Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah Awad","family":"Al Ibrahim","sequence":"additional","affiliation":[{"name":"Obstetrics and Fetal Medicine , Women\u2019s Hospital, Hamad Medical Corporation , Doha , Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rauf","family":"Ghani","sequence":"additional","affiliation":[{"name":"Obstetrician and Gynaecologist , Sidra Medical and Research Centre, Weill Cornell Medical College-Qatar , Doha , Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim","family":"Kalache","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Sidra Medical and Research Centre, Weill Cornell Medical College-Qatar , Doha , Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"2022012815324260376_j_jpm-2017-0189_ref_001","doi-asserted-by":"crossref","unstructured":"Jayaram PM, Okunoye GO, Konje J. 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