Pregnancy after laser therapy for the treatment of uterine cervical neoplasia.
Three hundred and twenty-four patients with cervical intraepithelial neoplasia (33 mild dysplasia, 109 moderate dysplasia, 118 severe dysplasia, 64 carcinoma in situ) underwent laser vaporization with the CO 2 laser. Eighty-two patients with CIN (mild dysplasia 7, moderate dysplasia 10, severe dysplasia 16, carcinoma in situ 46) and microinvasive cancer (3) underwent laser excisional conization with the YAG laser. Their first cure rates showed 93.5% and 98.8%, respectively, for the follow-up period 6 months to 7 years. During the same period, 36 pregnancies in 34 patients occurred. Of these patients, 14 underwent dilatation and curettage, 6 terminated by spontaneous abortion in the first trimester and 1 in the second trimester (previous MacDonald's suture), and 1 had fetal death at 13 weeks of gestational age. There were 13 deliveries, 2 by cesarean section (either postenucleation of uterine myoma or premature rupture of the membranes and fetal distress), 3 by vacuum extraction, 1 by breech delivery, and 7 by normal vaginal delivery. One patient is currently in her 22nd week of pregnancy. Our laser therapies are good conservative methods for the treatment of CIN because of favorable cure rates and no effect on succeeding pregnancy and delivery.
Department of Obstetrics and Gynecology, School of Medicine, Kitasato University, Sagamihira, Kanagawa, Japan.
K
K
Wakita
T
T
Izumi
H
H
Kuramoto
N
N
Sasaki
N
N
Shimada
D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005298:Fertility; D006801:Humans; D053685:Laser Therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors; D002578:Uterine Cervical Dysplasia / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000601:surgery*