Preterm delivery and premature rupture of membranes after conization in 80 women. Preliminary data.
OBJECTIVE
Cervical intraepithelial neoplasia is most frequently in young women in reproductive age. Cold knife conization, laser ablation, laser conization and large loop excision are conservative methods of treatment to remove the transformation zone and preserve the cervical function. Previous studies have shown conflicting results on the outcomes of pregnancy following these therapies that might increase the risk of preterm delivery. The purpose of this study was to evaluate the outcome of pregnancy after conization and its role as predictive risk factor.


METHODS
A retrospective study was performed. The study group comprised 80 women who had a conization and that had a subsequent singleton pregnancy. Variables considered includes maternal excision date, surgery procedure, previous surgery treatments, time interval between excisional procedure and subsequent pregnancy; duration and week of pregnancy, mode of delivery, histological grading (no cervical intraepithelial neoplasia [CIN], CIN 1, CIN 2-3) and cone excised depth.


RESULTS
In group study 45 women underwent loop electrosurgical excision procedure (LEEP) conization, 32 cold knife conization and 3 laser CO2. The authors found 11 cases of cone tissue depth<1 cm, and remaining one>1 cm. Eight preterm delivery have been reported to data: 5 between 28 and 34 weeks, 2 lower than 28 weeks and 1 between 34 and 37 weeks.


CONCLUSIONS
In these preliminary data the percentage of preterm birth appears as 10% and in range 6-15% evaluated for women not submitted to excisional procedures.
Patrelli
T S
TS
Department of Obstetrics, Gynecology and Neonatology, University of Parma, Parma, Italy. titopatrelli@hotmail.com
Anfuso
S
S
Vandi
F
F
Valitutto
S
S
Migliore
M
M
Salvati
M A
MA
De Ioris
A
A
Condemi
V
V
Fadda
G M
GM
Bacchi Modena
A
A
Nardelli
G B
GB
D000328:Adult; D019092:Conization / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology*; D006801:Humans; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*