title: Obstetrical prognosis of patients with cervical intraepithelial neoplasia (CIN) after "coin-shaped" conization.
abstract: OBJECTIVE
  Uterine cervical conization is related to adverse pregnancy outcomes in subsequent pregnancies. To deal with this problem, we started conservative coin-shaped conization for reproductive-aged patients with cervical intraepithelial neoplasia (CIN). Here we report both the obstetrical and oncological impacts of this operation in comparison with the standard cone-shaped resection.
  
  
  METHODS
  A total of 401 women 44 years old or younger were treated in our hospital by CO2 laser conization between 2003 and 2012, and subsequently 50 patients became pregnant. The patients were divided into two groups, a standard cone-shaped conization group (until 2008) and a shallow coin-shaped conization group (beginning in 2008). The pregnancy courses and oncological prognoses of these two groups were studied.
  
  
  RESULTS
  Cone height reduction of about 3 mm was done. However, there were no significant differences between the two groups with regard to the occurrence of oncological complications. In the standard conization group, 18 of the 25 patients delivered at term. In the coin-shaped conization group, 20 of the 25 patients delivered at term. There were no significant differences between the two groups with regard to the occurrence of various obstetrical complications. However, the reduction rate of cervical length over the pregnancy was smaller in the coin-shaped group and the number of patients with a short cervix length of 2 cm or less was smaller in the coin-shaped group.
  
  
  CONCLUSIONS
  Although conservative coin-shaped conization did not markedly improve the obstetrical prognosis, this operative procedure improved the reduction rate of uterine cervical length over the pregnancy without any increase in oncological complications.
authors: Department of Obstetrics and Gynecology, Sapporo Medical University, Minami 1 jo, Nishi 16 chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
authors: Miseon
authors: M
authors: Kim
authors: Department of Obstetrics and Gynecology, Sapporo Medical University, Minami 1 jo, Nishi 16 chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan. ishioka000@yahoo.co.jp.
authors: Shinichi
authors: S
authors: Ishioka
authors: Department of Obstetrics and Gynecology, Sapporo Medical University, Minami 1 jo, Nishi 16 chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
authors: Toshiaki
authors: T
authors: Endo
authors: Department of Obstetrics and Gynecology, Sapporo Medical University, Minami 1 jo, Nishi 16 chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
authors: Tsuyoshi
authors: T
authors: Baba
authors: Department of Obstetrics and Gynecology, Sapporo Medical University, Minami 1 jo, Nishi 16 chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
authors: Tsuyoshi
authors: T
authors: Saito
mesh_terms: D000293:Adolescent; D000328:Adult; D019092:Conization / Q000379:methods*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D054020:Lasers, Gas / Q000627:therapeutic use*; D009367:Neoplasm Staging; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*
keywords: CO2-laser therapy; Cervical intraepithelial neoplasia (CIN); Obstetrical and oncological outcomes; Preterm delivery