Risk factors for massive hemorrhage during the treatment of cesarean scar pregnancy: a systematic review and meta-analys
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REVIEW
Risk factors for massive hemorrhage during the treatment of cesarean scar pregnancy: a systematic review and meta‑analysis Yuan Zhang1,2,3 · Zhongyun Zhang4,5 · Xiaoyan Liu6 · Lei Zhang7 · Fanzhen Hong7 · Ming Lu1,2,3 Received: 27 February 2020 / Accepted: 4 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Cesarean scar pregnancy (CSP) is one of the serious complications associated with cesarean delivery (CD). This meta-analysis aims to identify risk factors associated with massive hemorrhage during the CSP treatment. Methods Eight electronic databases were searched for case–control studies published before December 31th, 2018, which compared the possible factors causing massive bleeding during the CSP treatment. Quantitative synthesis was performed by RevMan 5.3. Sensitivity analysis and publication bias were performed by Stata 12.0. Results Total 20 case − control studies including 3101 CSP patients with previous CD met the inclusion criteria. Bleeding group had 573 patients and the control group had 2528 patients. The risk factors for massive bleeding during CSP treatment included multiple gravidities (MD = 0.15, 95% CI 0.03–0.28, P = 0.73), big maximum diameter of gestation sac (MD = 18.49 mm, 95%CI 15.34–21.65, P
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