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Treatment of Cesarean Scar Ectopic Pregnancy in China with Uterine Artery Embolization—A Systematic Review and Meta-Analysis

Cesarean scar ectopic pregnancy (CSP) is a rare form of ectopic pregnancy, and treatment of CSP with uterine artery embolization (UAE) is a novel approach. With increasing numbers of cesarean sections being performed annually, the incidence of this condition is likely to increase. The authors became...

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Autores principales: Marchand, Greg J., Masoud, Ahmed Taher, Coriell, Catherine, Ulibarri, Hollie, Parise, Julia, Arroyo, Amanda, Goetz, Sydnee, Moir, Carmen, Moberly, Atley, Govindan, Malini
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783593/
https://www.ncbi.nlm.nih.gov/pubmed/36556010
http://dx.doi.org/10.3390/jcm11247393
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author Marchand, Greg J.
Masoud, Ahmed Taher
Coriell, Catherine
Ulibarri, Hollie
Parise, Julia
Arroyo, Amanda
Goetz, Sydnee
Moir, Carmen
Moberly, Atley
Govindan, Malini
author_facet Marchand, Greg J.
Masoud, Ahmed Taher
Coriell, Catherine
Ulibarri, Hollie
Parise, Julia
Arroyo, Amanda
Goetz, Sydnee
Moir, Carmen
Moberly, Atley
Govindan, Malini
author_sort Marchand, Greg J.
collection PubMed
description Cesarean scar ectopic pregnancy (CSP) is a rare form of ectopic pregnancy, and treatment of CSP with uterine artery embolization (UAE) is a novel approach. With increasing numbers of cesarean sections being performed annually, the incidence of this condition is likely to increase. The authors became aware of an unusually high number of published studies originating in mainland China regarding this unusual treatment and sought to perform a meta-analysis to provide comprehensive evidence on this novel practice. Methods: We performed a thorough search and included all forms of quality studies on this topic that reported UAE as a part of first-line management of CSP. We included only studies originating in China. Ultimately, 37 studies were included for qualitative and quantitative synthesis of evidence. After screening retrieved records and extracting data from eligible studies, we pooled continuous data as a mean estimate and 95% confidence interval (CI), and dichotomous data as proportion and 95% CI. Results: CSP patients treated with protocols including UAE had a mean time of 30 days for serum β-hCG normalization, 95% CI [26.816, 33.881]. They had a mean estimated intraprocedural blood loss of 4.19 ± 3.76 mL, a mean hospital stay of nine days, 95%CI [7.914, 9.876], and a success rate of 93.4%, 95%CI [0.918, 0.951]. The severe complication rate was 1.2%, 95%CI [0.008, 0.017]. Conclusion: UAE, in combination with other procedures is being used effectively for the treatment of CSP in China. Protocols including UAE have a success rate of approximately 93.4%, and a severe complication rate of approximately 1.2%. This data’s utility is limited by vast differences in the studied protocols and questionable feasibility outside of China.
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spelling pubmed-97835932022-12-24 Treatment of Cesarean Scar Ectopic Pregnancy in China with Uterine Artery Embolization—A Systematic Review and Meta-Analysis Marchand, Greg J. Masoud, Ahmed Taher Coriell, Catherine Ulibarri, Hollie Parise, Julia Arroyo, Amanda Goetz, Sydnee Moir, Carmen Moberly, Atley Govindan, Malini J Clin Med Review Cesarean scar ectopic pregnancy (CSP) is a rare form of ectopic pregnancy, and treatment of CSP with uterine artery embolization (UAE) is a novel approach. With increasing numbers of cesarean sections being performed annually, the incidence of this condition is likely to increase. The authors became aware of an unusually high number of published studies originating in mainland China regarding this unusual treatment and sought to perform a meta-analysis to provide comprehensive evidence on this novel practice. Methods: We performed a thorough search and included all forms of quality studies on this topic that reported UAE as a part of first-line management of CSP. We included only studies originating in China. Ultimately, 37 studies were included for qualitative and quantitative synthesis of evidence. After screening retrieved records and extracting data from eligible studies, we pooled continuous data as a mean estimate and 95% confidence interval (CI), and dichotomous data as proportion and 95% CI. Results: CSP patients treated with protocols including UAE had a mean time of 30 days for serum β-hCG normalization, 95% CI [26.816, 33.881]. They had a mean estimated intraprocedural blood loss of 4.19 ± 3.76 mL, a mean hospital stay of nine days, 95%CI [7.914, 9.876], and a success rate of 93.4%, 95%CI [0.918, 0.951]. The severe complication rate was 1.2%, 95%CI [0.008, 0.017]. Conclusion: UAE, in combination with other procedures is being used effectively for the treatment of CSP in China. Protocols including UAE have a success rate of approximately 93.4%, and a severe complication rate of approximately 1.2%. This data’s utility is limited by vast differences in the studied protocols and questionable feasibility outside of China. MDPI 2022-12-13 /pmc/articles/PMC9783593/ /pubmed/36556010 http://dx.doi.org/10.3390/jcm11247393 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Marchand, Greg J.
Masoud, Ahmed Taher
Coriell, Catherine
Ulibarri, Hollie
Parise, Julia
Arroyo, Amanda
Goetz, Sydnee
Moir, Carmen
Moberly, Atley
Govindan, Malini
Treatment of Cesarean Scar Ectopic Pregnancy in China with Uterine Artery Embolization—A Systematic Review and Meta-Analysis
title Treatment of Cesarean Scar Ectopic Pregnancy in China with Uterine Artery Embolization—A Systematic Review and Meta-Analysis
title_full Treatment of Cesarean Scar Ectopic Pregnancy in China with Uterine Artery Embolization—A Systematic Review and Meta-Analysis
title_fullStr Treatment of Cesarean Scar Ectopic Pregnancy in China with Uterine Artery Embolization—A Systematic Review and Meta-Analysis
title_full_unstemmed Treatment of Cesarean Scar Ectopic Pregnancy in China with Uterine Artery Embolization—A Systematic Review and Meta-Analysis
title_short Treatment of Cesarean Scar Ectopic Pregnancy in China with Uterine Artery Embolization—A Systematic Review and Meta-Analysis
title_sort treatment of cesarean scar ectopic pregnancy in china with uterine artery embolization—a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783593/
https://www.ncbi.nlm.nih.gov/pubmed/36556010
http://dx.doi.org/10.3390/jcm11247393
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