Pregnancy outcome after loop electrosurgical excision procedure for cervical intraepithelial neoplasia

被引:49
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
[11]   Long-term mortality in women treated for cervical intraepithelial neoplasia [J].
Jakobsson, M. ;
Gissler, M. ;
Paavonen, J. ;
Tapper, A-M .
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2009, 116 (06) :838-844
[12]   Treatment for cervical intraepithelial neoplasia and subsequent IVF deliveries [J].
Jakobsson, Maija ;
Gissler, Mika ;
Tiitinen, Aila ;
Paavonen, Jorma ;
Tapper, Anna-Maija .
HUMAN REPRODUCTION, 2008, 23 (10) :2252-2255
[13]   Preterm delivery after surgical treatment for cervical intraepithelial neoplasia [J].
Jakobsson, Maija ;
Gissler, Mika ;
Sainio, Susanna ;
Paavonen, Jorma ;
Tapper, Anna-Maija .
OBSTETRICS AND GYNECOLOGY, 2007, 109 (02) :309-313
[14]   The thickness and volume of LLETZ specimens can predict the relative risk of pregnancy-related morbidity [J].
Khalid, S. ;
Dimitriou, E. ;
Conroy, R. ;
Paraskevaidis, E. ;
Kyrgiou, M. ;
Harrity, C. ;
Arbyn, M. ;
Prendiville, W. .
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2012, 119 (06) :685-691
[15]   Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis [J].
Kyrgiou, M ;
Koliopoulos, G ;
Martin-Hirsch, P ;
Arbyn, M ;
Prendiville, W ;
Paraskevaidis, E .
LANCET, 2006, 367 (9509) :489-498
[16]   Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population-based study of singleton deliveries during a 9-year period [J].
Noehr, Bugge ;
Jensen, Allan ;
Frederiksen, Kirsten ;
Tabor, Ann ;
Kjaer, Susanne K. .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2009, 201 (01) :33.e1-33.e6
[17]   LARGE LOOP EXCISION OF THE TRANSFORMATION ZONE (LLETZ) - A NEW METHOD OF MANAGEMENT FOR WOMEN WITH CERVICAL INTRAEPITHELIAL NEOPLASIA [J].
PRENDIVILLE, W ;
CULLIMORE, J ;
NORMAN, S .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1989, 96 (09) :1054-1060
[18]   Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics [J].
Quinn, M ;
Babb, P ;
Jones, J ;
Allen, E .
BRITISH MEDICAL JOURNAL, 1999, 318 (7188) :904-+
[19]   Prevention of spontaneous preterm birth: the role of sonographic cervical length in identifying patients who may benefit from progesterone treatment [J].
Romero, Roberto .
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2007, 30 (05) :675-686
[20]   Treatment for cervical intraepithelial neoplasia and risk of preterm delivery [J].
Sadler, L ;
Saftlas, A ;
Wang, WQ ;
Exeter, M ;
Whittaker, J ;
McCowan, L .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (17) :2100-2106