Textbook outcomes in patients with a cesarean scar pregnancy: A comprehensive analysis from a single Eastern center

Author:

Wu Zhi-Wei1,Lin Cheng-Bin1,Lin Ying-Ying1,Cai Yuan-Jun1,Xie Li1

Affiliation:

1. Fujian Maternity and Child Health Hospital, Fujian Medical University

Abstract

Abstract

Background Quality medical care is crucial in evaluating clinical results. This study assessed the value of medical quality control using the comprehensive indicator "textbook outcome" (TO) in patients with a cesarean scar pregnancy (CSP). Methods This study included 140 patients from a CSP cohort from April 2022 to May 2024. TO was characterized by the total removal of the gestational sac, lack of intraoperative complications, absence of severe postoperative complications, freedom from re-interventions, no unplanned admissions to the intensive care unit, postoperative hospital stay of ≤ 7 days, zero postoperative mortalities within 30 days post-surgery, and no readmission within 30 days post-surgery. Logistic regression was used to analyze factors contributing to non-TO. Results Overall, 119 (85.0%) achieved a TO. Significant differences were observed between the TO and non-TO groups in terms of the number of days with abdominal pain, number of days with vaginal bleeding, number of days without menstruation, history of cesarean section in a primary healthcare hospital, time from previous cesarean section to CSP, gestational sac size, and CSP classification (all P < 0.05). Most patients in the TO group received high-intensity focused ultrasound (HIFU) combined with hysteroscopy (53.8%), resulting in lower average intraoperative blood loss, length of hospital stay, and hospitalization cost compared to the non-TO group (all P < 0.05). The postoperative pain score in the TO group was lower (P = 0.002), and the time required for β-hCG levels to return to normal in the TO group was shorter than in the non-TO group (P = 0.025). Multivariate logistic analysis revealed that history of cesarean section at a primary hospital, CSP-III classification, and intraoperative blood loss exceeding 30 mL were independent risk factors for a non-TO (all P < 0.05), whereas HIFU combined with hysteroscopy was an independent protective factor against non-TO (P = 0.020). Conclusion In clinical practice, it is important to pay attention to patients with history of cesarean section in primary healthcare hospitals, CSP-III classification, and intraoperative blood loss exceeding 30 mL. HIFU combined with hysteroscopy can help patients with a CSP achieve a TO.

Publisher

Springer Science and Business Media LLC

Reference32 articles.

1. First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar;Jurkovic D;Ultrasound Obstet Gynecol,2003

2. Cesarean scar pregnancy; Diagnosis and management between 2003 and 2015 in a single center;Kim SY;Taiwan J Obstet Gynecol,2018

3. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08;Lumbiganon P;Lancet,2010

4. [Expert opinion of diagnosis and treatment of cesarean scar pregnancy. (2016)]. Zhonghua Fu Chan Ke Za Zhi. 2016;51:568 – 72.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3