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Войти в исследования European journal of obstetrics, gynecology, and reproductive biology · 2026
The role of Hysteroscopy in the management of caesarean scar pregnancy: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Silva Marta Sousa, Pinto Pedro Viana, Vieira Rafael José
Аннотация
OBJECTIVE: To evaluate the effectiveness, safety, and clinical applicability of hysteroscopy (HSC) in the management of caesarean scar pregnancy (CSP) and to assess its potential role as a first-line treatment.
DATA SOURCES: We conducted a search in MEDLINE (via Ovid), Scopus and Web of Science from inception through May 2, 2025.
STUDY ELIGIBILITY CRITERIA: The protocol is registered in PROSPERO (CRD420251004342). Articles were eligible if: (1) CSP patients were managed with operative HSC; (2) HSC was the primary therapeutic approach and not an adjuvant; (3) the treatment regimen, adverse effects, outcomes and success rate were reported; (4) observational or interventional studies.
STUDY APPRAISAL AND SYNTHESIS METHODS: This systematic review followed the PRISMA 2020 guidelines. Two authors independently screened titles and abstracts using predefined inclusion and exclusion criteria. We performed multilevel and random-effects meta-analyses of proportions to pool success and complication rates. Univariable meta-regression was performed to explore pontencial sources of heterogeneity.
RESULTS: The review included 28 articles with 4258 CSP patients, of whom 2587 were treated with HSC. The overall success rate was 94% with a complication rate of 4%. Success rates were comparable for HSC alone (95%), methotrexate and HSC (91%), and uterine artery embolization plus HSC (90%). The complication rate was 4%, 5% and 0%, respectively.
CONCLUSIONS: HSC is a safe, effective fertility-preserving option in hemodynamically stable patients in the management of CSP, with a low risk of complications, including hysterectomy. This procedure can be used alone or in combination with other treatments.
DATA SOURCES: We conducted a search in MEDLINE (via Ovid), Scopus and Web of Science from inception through May 2, 2025.
STUDY ELIGIBILITY CRITERIA: The protocol is registered in PROSPERO (CRD420251004342). Articles were eligible if: (1) CSP patients were managed with operative HSC; (2) HSC was the primary therapeutic approach and not an adjuvant; (3) the treatment regimen, adverse effects, outcomes and success rate were reported; (4) observational or interventional studies.
STUDY APPRAISAL AND SYNTHESIS METHODS: This systematic review followed the PRISMA 2020 guidelines. Two authors independently screened titles and abstracts using predefined inclusion and exclusion criteria. We performed multilevel and random-effects meta-analyses of proportions to pool success and complication rates. Univariable meta-regression was performed to explore pontencial sources of heterogeneity.
RESULTS: The review included 28 articles with 4258 CSP patients, of whom 2587 were treated with HSC. The overall success rate was 94% with a complication rate of 4%. Success rates were comparable for HSC alone (95%), methotrexate and HSC (91%), and uterine artery embolization plus HSC (90%). The complication rate was 4%, 5% and 0%, respectively.
CONCLUSIONS: HSC is a safe, effective fertility-preserving option in hemodynamically stable patients in the management of CSP, with a low risk of complications, including hysterectomy. This procedure can be used alone or in combination with other treatments.