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Obstetric Outcomes After Treatment for Cervical Intraepithelial Neoplasia

2011; Lippincott Williams & Wilkins; Volume: 15; Issue: 4 Linguagem: Inglês

10.1097/lgt.0b013e31821a6823

1526-0976

Ana Furtado Lima, Carla Francisco, Catarina Júlio, Tereza Paula, Adelaide Vitorino, Jorge Borrego,

Preterm Birth and Chorioamnionitis

In Brief Objective: The purpose of this study was to assess the effect of cervical conization on subsequent pregnancy and delivery outcomes. Materials and Methods: A retrospective case-control study was performed in patients who underwent conization from 2000 to 2005 and had a subsequent delivery. Two case controls were matched for each case studied. The obstetric outcomes of the 2 groups were compared. A subsequent analysis comparing the 2 excisional techniques used was performed. Results: The study population group included 87 women (29 cases and 58 controls). Overall, the mean gestation age at delivery (38 vs 39 wk, p = .003), prevalence of preterm birth (20.7% vs 5.2%, p = .025), mean birth weight (3,035 vs 3279 g, p = .018), and low birth weight (20.7% vs 1.7%, p = .02) were statistically different among the cases and controls. In the study group (n = 29), large loop excision of the transformation zone was used in 62% (n = 18) and laser was used in 38% (n = 11) of the cases. There was no significant difference in the medium depth of the excised tissue, the prevalence of preterm birth, low birth weight, and the cesarean delivery rate between the 2 techniques. Conclusions: Despite the small number of cases, this study indicates that excision of the transformation zone is associated with an increased risk of overall preterm delivery and low-birth weight infants in subsequent pregnancies. No significant difference was found between the 2 cervical excision procedures. Cervical excision procedures increase risk of preterm delivery and low-birth weight infants in subsequent pregnancies, but there is no difference between LLETZ and laser cone.