title: Obstetric and neonatal outcome after surgical treatment of cervical dysplasia.
abstract: OBJECTIVE
  Conization is the gold standard today for the management of severe cervical dysplasia. However, with the increasing delay until first pregnancy, obstetric follow-up of patients with a history of conization is a growing concern.
  
  
  METHODS
  Retrospective case-control study using data from the electronic database of a university hospital. We compared the obstetric and neonatal outcome of 106 pregnancies delivered after conization with the outcome of 212 pregnancies of patients with no history of conization.
  
  
  RESULTS
  A significant reduction in the mean gestational age at delivery (38.23 ± 2.51 weeks vs. 39.15 ± 1.56 weeks) was observed, together with a higher rate of premature rupture of the membrane (9.4% vs. 1.9%), premature onset of labor (9.4% vs. 2.4%), premature delivery (17% vs. 3.8%) and neonatal hospitalization (17.9% vs. 6.6%) in the group of patients with history of conization. Children born to women who had surgery had a significantly lower birth weight (3146.9 ± 611 g vs. 3347.3 ± 502 g) and size (49.1 ± 2.6 cm vs. 50.0 cm ± 2.2 cm) than those of the control group. Furthermore, these children were more frequently admitted in the neonatal intensive care unit (22.6% vs. 10.4%, p=0.004).
  
  
  CONCLUSIONS
  Conization is an important risk factor for premature birth and women with a history of conization require cautious obstetric management during pregnancy. Anti-HPV vaccination and proactive surveillance of low-grade or moderate dysplasia, instead of immediate surgery, should be encouraged in young patients.
authors.affiliation: Department of Obstetrics and Gynecology, ULB Erasme Hospital, 808 Route de Lennik, 1070 Brussels, Belgium.
authors.forename: Marie
authors.initials: M
authors.lastname: Van Hentenryck
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Noel
authors.forename: Philippe
authors.initials: P
authors.lastname: Simon
mesh_terms: D001724:Birth Weight; D016022:Case-Control Studies; D019092:Conization / Q000009:adverse effects*; D016208:Databases, Factual; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000601:surgery*