CSP Registry
Research type
Research Study
Full title
Cesarean Scar Pregnancy Registry (CSP Registry)
IRAS ID
246295
Contact name
Andrea Kaelin
Contact email
Sponsor organisation
Liverpool Women's NHS Foundation Trust
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Globally, the number of caesarean sections have increased over the last 30 years. In England, 11.5% of expectant mothers had 2016 a planned caesarean section (4% in 1980) and 15.6% of women had an unplanned caesarean section, according to NHS statistics. Paralleling this increase of caesarean sections, caesarean scar pregnancies (CSP) have risen as well. The true incidence of CSP is unknown, estimates are 1 in 1800 to 1 in 2500 of all caesarean sections performed. In CSP the gestational sac is implanted the uterine scar. Caesarean scar pregnancies are a serious and potentially dangerous clinical entity. A systematic review assessing the different treatment methods for CSP showed a complication rate of 44.1%,5 mainly secondary to missed diagnoses or potentially inappropriate treatments that caused heavy bleeding. To date, there is still no agreed-upon management protocol for CSP. Clinicians all over the world manage CSP far differently. Therefore, there is a critical need to share data about the diagnosis and management amongst clinicians and researchers. We aim to extract the maximum scientific knowledge from all available datasets. We assembled a multi-disciplinary team of clinician scientists to produce a secure, online data platform. We hypothesize that by studying the diagnosis itself, the clinical ultrasound parameters and the different management modalities, both in women who wish to terminate or to continue their pregnancy, we will able to provide the basis for a standardized treatment protocol for CSP. Only by analyzing large numbers of cases,it will it be possible to identify all the risks specific to CSP and at different gestational ages. This will influence subsequent management.
Lay summary of study results: The CSP registry recorded 708 cases of Caesarean Scar Pregnancies (CSP). The results showed that surgery is much more effective and safer than medical treatment. 90% of pregnant people with CSP were treated effectively with suction evacuation or surgical excision. The minimally invasive double balloon treatment was also effective, however had a high number of patients requiring emergency removal of the womb as a complication.
Summary Results: https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fwww.ajog.org%252Farticle%252FS0002-9378&data=05%7C02%7CTracy.Hamrang%40hra.nhs.uk%7Cb0f4c643f61f40494f4d08dd14598574%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638689096901908773%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=Nh2mpGJPqKqBdvIC4hP4sSjeyMIikiDFwMzGooAgI%2BA%3D&reserved=0(23)00758-5%2Ffulltext/NBTI/agq5AQ/AQ/27ff2023-a6a0-4448-af7a-89f2d221b8c8/1/EbvQ9lCsg3REC name
London - City & East Research Ethics Committee
REC reference
18/LO/1268
Date of REC Opinion
29 Aug 2018
REC opinion
Favourable Opinion