Abstract：
OBJECTIVE: To determine whether the new classification system published by Jordans et al for cesarean scar pregnancy (CSP) can guide management and treatment outcomes.
METHODS: A retrospective study of women diagnosed with CSP from October 2010 to December 2022 in a single tertiary center was performed. Sonographic records of these women were classified into three types according to the classification published by Jordans et al. Treatment outcomes were compared across each type of CSP.
RESULTS: The study included a total of 84 women, where 60 (71.4%), 17 (20.2%), and 7 (8.3%) of them were categorized into Type 1, 2, and 3 CSP, respectively. A total of 47 (55.9%) women were managed with methotrexate, 22 (26.2%) underwent surgical management of the CSP without removal of the Cesarean section (CS) niche, and 11 (13.1%) underwent surgery to remove the CSP and the CS niche. Overall treatment success rates for medical management and surgical management were 70 and 97%, respectively. Four women were managed expectantly and continued their pregnancies, among which three carried beyond 34 weeks and had good neonatal outcomes.
CONCLUSIONS: The classification as published by Jordans et al is easily replicable and readily implemented clinically. Our findings show that a higher proportion of Type 1 and Type 2 CSP were treated successfully by a less invasive medical approach with a high success rate, whereas most Type 3 CSP required surgical resection to successfully remove the CSP and the CS niche. Prospective studies are required to confirm these findings and further validate the clinical utility of this nomenclature system.
METHODS: A retrospective study of women diagnosed with CSP from October 2010 to December 2022 in a single tertiary center was performed. Sonographic records of these women were classified into three types according to the classification published by Jordans et al. Treatment outcomes were compared across each type of CSP.
RESULTS: The study included a total of 84 women, where 60 (71.4%), 17 (20.2%), and 7 (8.3%) of them were categorized into Type 1, 2, and 3 CSP, respectively. A total of 47 (55.9%) women were managed with methotrexate, 22 (26.2%) underwent surgical management of the CSP without removal of the Cesarean section (CS) niche, and 11 (13.1%) underwent surgery to remove the CSP and the CS niche. Overall treatment success rates for medical management and surgical management were 70 and 97%, respectively. Four women were managed expectantly and continued their pregnancies, among which three carried beyond 34 weeks and had good neonatal outcomes.
CONCLUSIONS: The classification as published by Jordans et al is easily replicable and readily implemented clinically. Our findings show that a higher proportion of Type 1 and Type 2 CSP were treated successfully by a less invasive medical approach with a high success rate, whereas most Type 3 CSP required surgical resection to successfully remove the CSP and the CS niche. Prospective studies are required to confirm these findings and further validate the clinical utility of this nomenclature system.
摘要：
目的：确定Jordans等人发布的剖宫产瘢痕妊娠（CSP）的新分类系统是否可以指导治疗和治疗结果。
方法：对2010年10月至2022年12月在一个三级中心诊断为CSP的女性进行了回顾性研究。根据Jordans等人发表的分类，将这些女性的超声记录分为三种类型。在每种类型的CSP中比较治疗结果。
结果：该研究共包括84名女性，其中60（71.4%），17（20.2%），其中7个(8.3%)分为1、2和3型CSP，分别。共有47名(55.9%)女性接受甲氨蝶呤治疗，22（26.2％）接受了CSP的手术治疗，但未切除剖宫产（CS）利基，11例(13.1%)接受手术切除CSP和CS小生境。医疗管理和手术管理的总体治疗成功率分别为70％和97％，分别。四名妇女得到了预期的管理，并继续怀孕，其中3例超过34周，新生儿结局良好。
结论：Jordans等人发表的分类易于复制且易于临床实施。我们的发现表明，较高比例的1型和2型CSP通过较低的侵入性医疗方法成功治疗，成功率很高。而大多数3型CSP需要手术切除才能成功切除CSP和CS生态位。需要前瞻性研究来确认这些发现，并进一步验证该命名系统的临床实用性。
方法：对2010年10月至2022年12月在一个三级中心诊断为CSP的女性进行了回顾性研究。根据Jordans等人发表的分类，将这些女性的超声记录分为三种类型。在每种类型的CSP中比较治疗结果。
结果：该研究共包括84名女性，其中60（71.4%），17（20.2%），其中7个(8.3%)分为1、2和3型CSP，分别。共有47名(55.9%)女性接受甲氨蝶呤治疗，22（26.2％）接受了CSP的手术治疗，但未切除剖宫产（CS）利基，11例(13.1%)接受手术切除CSP和CS小生境。医疗管理和手术管理的总体治疗成功率分别为70％和97％，分别。四名妇女得到了预期的管理，并继续怀孕，其中3例超过34周，新生儿结局良好。
结论：Jordans等人发表的分类易于复制且易于临床实施。我们的发现表明，较高比例的1型和2型CSP通过较低的侵入性医疗方法成功治疗，成功率很高。而大多数3型CSP需要手术切除才能成功切除CSP和CS生态位。需要前瞻性研究来确认这些发现，并进一步验证该命名系统的临床实用性。
