The first study
A number of conditions were prioritised by a nationally representative group of clinicians and patients, and from these, caesarean scar pregnancy has been selected as the first condition for study. In this condition the pregnancy is surrounded by myometrium and fibrous tissue of the scar of a previous caesarean section. It is estimated to occur in 0.15% of women with a history of at least one caesarean delivery. The number of reported cases has increased over recent years, possibly reflecting the rising number of caesareans being performed and the more widespread use of transvaginal ultrasonography.
We aim to research how the condition is diagnosed, its incidence, what symptoms and signs the patients present with, risk factors, treatment and outcomes.
Applications will be invited from clinicians and researchers for inclusion of suitable studies into the surveillance system. They will be considered by the UKEPSS steering committee, which consists of representatives from the Royal College of Obstetricians and Gynaecologists, the Miscarriage Association, the Association of Early Pregnancy Units, the Early Pregnancy Clinical Studies Group, the Ectopic Pregnancy Trust and independent members. The committee will meet every four months to consider applications for the inclusion of new studies into the scheme, and the conduct of existing studies.
Potential studies will be considered against the following criteria:
- The condition is an important cause of maternal morbidity and/or mortality.
- The condition is an uncommon disorder of pregnancy, thus inclusion within the study programme of UKEPSS will not impose too great a burden on reporting clinicians (usually no more than one case per 2000 pregnancies annually in the UK).
- The research questions posed by the study can be suitably addressed using the UKEPSS methodology (prospective descriptive, cohort or case–control studies).
- Other sources of information exist to enhance and/or assess completeness of data collection.
- Caesarean scar pregnancies
- Complex ovarian tumours in pregnancy
- Critical hyperemesis
- Uterine perforations during evacuation of the uterus
- Interstitial ectopic pregnancy
- Pelvic infection during pregnancy