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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 1 مورد

Cesarean scar pregnancy: Examples of different classification systems

Cesarean scar pregnancy: Examples of different classification systems
Kaelin Agten et al., 2017[1] On-the-scar:

Implantation of the CSP on the well-healed scar of a previous cesarean birth (also termed "endogenous" implantation)

 In-the-niche:

Implantation of the CSP within the defect or "niche" of an incompletely healed scar (also termed "niche pregnancy," or "exogenous" implantation)
Lin et al., 2018[2] Grade I:

CSP embedded in less than one-half of the thickness of the lower anterior corpus

 Grade II:

CSP embedded in more than one-half of the thickness of the lower anterior corpus

 Grade III:

Gestational sac bulges out from the uterine serosa

 Grade IV:

Gestational sac appears as an amorphous tumor with rich vascularity at the cesarean scar
Xu et al., 2022[3]

Partial implantation of the gestational sac in the uterine scar, and

Thinning of the myometrium between the gestational sac and the bladder, and

Type III:

  • Complete implantation of the gestational sac in the uterine scar and convex toward the bladder; or
  • A mixed echogenic mass in the lower uterine scar, with the mass bulging toward the bladder, color Doppler shows a rich blood-flow signal around the mass; or
  • Significant thinning or absent myometrium between the gestational sac and the bladder, thickness ≤3 mm

Type I:

  • Myometrial thickness >3 mm

Type II:

  • Myometrial thickness ≤3 mm
Ban et al., 2023[4] Type I:

Implantation of a gestational sac within the cesarean scar; anterior myometrium thickness >3 mm

 Type II:

Implantation of a gestational sac within the cesarean scar; anterior myometrium thickness 1 to 3 mm

 Type III:

Gestational sac bulges out from the cesarean scar; anterior myometrium thickness ≤1 mm
IIa:

Average diameter of the gestational sac or mass ≤30 mm

 IIb:

Average diameter of the gestational sac or mass >30 mm

 IIIa:

Average diameter of the gestational sac or mass ≤50 mm

 IIIb:

Average diameter of the gestational sac or mass >50 mm or with uterine arteriovenous fistula
CSP: cesarean scar pregnancy.
References:
  1. Kaelin Agten A, Cali G, Monteagudo A, et al. The clinical outcome of cesarean scar pregnancies implanted "on the scar" versus "in the niche." Am J Obstet Gynecol 2017; 216:510.e1.
  2. Lin SY, Hsieh CJ, Tu YA, et al. New ultrasound grading system for cesarean scar pregnancy and its implications for management strategies: An observational cohort study. PLoS One 2018; 13:e0202020.
  3. Xu Z, Sheng C, Yang Q, et al. Analysis of pregnancy outcomes following surgical treatment of cesarean scar pregnancy. BMC Pregnancy Childbirth 2022; 22:644.
  4. Ban Y, Shen J, Wang X, et al. Cesarean scar ectopic pregnancy clinical classification system with recommended surgical strategy. Obstet Gynecol 2023; 141:927.
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