Pregnancy outcome after loop electrosurgical excision procedure for cervical intraepithelial neoplasia

被引:47
作者
Frega, Antonio [1 ]
Sesti, Francesco [2 ,3 ]
De Sanctis, Luana [1 ]
Pacchiarotti, Arianna [1 ]
Votano, Sergio [4 ]
Biamonti, Alberto [5 ]
Sopracordevole, Francesco [6 ]
Scirpa, Paolo [7 ]
Catalano, Angelica [1 ]
Caserta, Donatella [1 ]
Gentile, Marco [1 ]
Schimberni, Mauro [1 ]
Moscarini, Massimo [1 ]
机构
[1] Univ Roma La Sapienza, SantAndrea Hosp, Dept Gynecol Obstet & Urol Sci, I-00189 Rome, Italy
[2] Tor Vergata Univ Hosp, Sect Gynecol, Acad Dept Biomed & Prevent, Rome, Italy
[3] Tor Vergata Univ Hosp, Clin Dept Surg, Rome, Italy
[4] San Carlo Hosp IDI IRCCS, Dept Obstet & Gynaecol, Rome, Italy
[5] Cristo Re Hosp, Dept Obstet & Gynaecol, Rome, Italy
[6] Natl Canc Inst, Dept Gynaecol Oncol, Aviano, Italy
[7] Univ Cattolica Sacro Cuore, Dept Obstet & Gynecol, I-00168 Rome, Italy
关键词
Cervical length; Cervical intraepithelial neoplasia; Cone size; Loop electrosurgical excision procedure; Nulliparous; Obstetric outcomes; Preterm delivery; Spontaneous abortion; PRIOR CONE BIOPSY; PRETERM BIRTH; WOMEN; RISK; MORTALITY; CONIZATION; MANAGEMENT; ENGLAND; LENGTH; LLETZ;
D O I
10.1016/j.ijgo.2013.03.013
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To determine pregnancy outcomes among women who underwent loop electrosurgical excision procedure (LEEP). Methods: In a case-control study in Italy, 475 pregnant women who underwent LEEP and 441 untreated pregnant women were enrolled between January 2003 and January 2007. Outcome measures were spontaneous abortion, preterm delivery, and at-term delivery rates. Continuous and discrete variables were analyzed via t, chi(2), and Fisher exact tests. Groups were compared by analysis of variance and Tukey HSD test. Results: The spontaneous abortion rate was 14.5% and 14.1% in the LEEP and untreated groups, respectively. The preterm delivery rate was 6.4% and 5.0% in the LEEP and untreated groups, respectively. The number of women with a cervical length of less than 30 mm was higher in the LEEP group, but this did not influence preterm delivery rate (odds ratio [OR], 1.01; 95% confidence interval [CI], 0.53-1.95). Among women with a cervical length of less than 15 mm, those treated with a wider removal of cervical tissue showed increased risk of preterm delivery (OR, 5.31; 95% CI, 1.01-28.07). Conclusion: The preterm delivery rate was not higher among women who underwent LEEP than among untreated women. Preterm delivery was associated with cone size and cervical length in the second trimester. (C) 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:145 / 149
页数:5
相关论文
共 25 条
[1]   Pregnancy outcome in patients treated with cervical conization for cervical intraepithelial neoplasia [J].
Andia, Daniel ;
Mozo de Rosales, Fernando ;
Villasante, Amparo ;
Rivero, Borja ;
Diez, Javier ;
Perez, Carlos .
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2011, 112 (03) :225-228
[2]   Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis [J].
Arbyn, M. ;
Kyrgiou, M. ;
Simoens, C. ;
Raifu, A. O. ;
Koliopoulos, G. ;
Martin-Hirsch, P. ;
Prendiville, W. ;
Paraskevaidis, E. .
BMJ-BRITISH MEDICAL JOURNAL, 2008, 337 (7673) :798-803
[3]   Obstetric outcome following cervical conization [J].
Armarnik, Sharon ;
Sheiner, Eyal ;
Piura, Benjamin ;
Meirovitz, Mihai ;
Zlotnik, Alexander ;
Levy, Amalia .
ARCHIVES OF GYNECOLOGY AND OBSTETRICS, 2011, 283 (04) :765-769
[4]   Prior cone biopsy: Prediction of preterm birth by cervical ultrasound [J].
Berghella, V ;
Pereira, L ;
Gariepy, A ;
Simonazzi, G .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2004, 191 (04) :1393-1397
[5]   Gestational age at cervical length measurement and incidence of preterm birth [J].
Berghella, Vincenzo ;
Roman, Amanda ;
Daskalakis, Constantine ;
Ness, Amen ;
Baxter, Jason K. .
OBSTETRICS AND GYNECOLOGY, 2007, 110 (02) :311-317
[6]   Cervical conization and the risk of preterm delivery [J].
Bevis, Kerri S. ;
Biggio, Joseph R. .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2011, 205 (01) :19-27
[7]   Risk of preterm birth after treatment for cervical intraepithelial neoplasia among women attending colposcopy in England: retrospective-prospective cohort study [J].
Castanon, Alejandra ;
Brocklehurst, Peter ;
Evans, Heather ;
Peebles, Donald ;
Singh, Naveena ;
Walker, Patrick ;
Patnick, Julietta ;
Sasieni, Peter .
BMJ-BRITISH MEDICAL JOURNAL, 2012, 345
[8]   Cervical sonography in pregnant women with a prior cone biopsy or loop electrosurgical excision procedure [J].
Fischer, R. L. ;
Sveinbjornsson, G. ;
Hansen, C. .
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2010, 36 (05) :613-617
[9]   Cervical intraepithelial neoplasia grade III (CIN III) and invasive cervical carcinoma: the yawning gap revisited and the treatment of risk [J].
Herbert, A ;
Smith, JAE .
CYTOPATHOLOGY, 1999, 10 (03) :161-170
[10]   Time from cervical conization to pregnancy and preterm birth [J].
Himes, Katherine P. ;
Simhan, Hyagriv N. .
OBSTETRICS AND GYNECOLOGY, 2007, 109 (02) :314-319