title: The role of prophylactic cerclage in preventing preterm delivery after electrosurgical conization.
abstract: OBJECTIVE
  To evaluate pregnancy outcomes after electrosurgical conization.
  
  
  METHODS
  We retrospectively analyzed the outcomes of 56 singleton pregnancies after electrosurgical conization of the uterine cervix. Of the 56 cases, 25 women underwent prophylactic cerclage with McDonald procedure (cerclage group), and 31 were managed expectantly (expectant group). Pregnancy outcomes including rate of preterm delivery were compared, and the effect of potential risk factors such as depth of cone, interval between conization and pregnancy, and cervical length on the risk of preterm delivery was assessed.
  
  
  RESULTS
  The rate of preterm delivery was significantly higher in women with a history of electrosurgical conization than those without (32.1% vs. 15.2%, p<0.001). However, preterm delivery rate was not different between the two groups (expectant group vs. cerclage group; <28 week, 6.5% vs. 8.0%, p=1.000; <34 week, 19.4% vs. 20.0%, p=1.000; <37 week, 29.0% vs. 36.0%, p=0.579). All obstetric and neonatal outcomes were similar in the two groups. Even when we confined the study subjects to 19 women (19/56, 33.9%) with cervical length less than 25 mm, the preterm delivery rate also was not significantly different between the expectant (n=7) and cerclage group (n=12). Finally, the potential risk factors for preterm delivery were not associated with risk of preterm delivery in patients with a history of electrosurgical conization.
  
  
  CONCLUSIONS
  The rate of preterm delivery was significantly higher in women with a history of electrosurgical conization before pregnancy. However, prophylactic cervical cerclage did not prevent preterm delivery in these patients.
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Mi-Young
authors.initials: MY
authors.lastname: Shin
authors.forename: Eun-Sung
authors.initials: ES
authors.lastname: Seo
authors.forename: Suk-Joo
authors.initials: SJ
authors.lastname: Choi
authors.forename: Soo-Young
authors.initials: SY
authors.lastname: Oh
authors.forename: Byoung-Gie
authors.initials: BG
authors.lastname: Kim
authors.forename: Duk-Soo
authors.initials: DS
authors.lastname: Bae
authors.forename: Jong-Hwa
authors.initials: JH
authors.lastname: Kim
authors.forename: Cheong-Rae
authors.initials: CR
authors.lastname: Roh