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KMID : 0361720100210030273
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Korean Journal of perinatology
2010 Volume.21 No. 3 p.273 ~ p.281
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Pregnancy Outcomes after Conservative Treatment of Cervical Intraepithelial Lesions: Cold Knife Conization and Loop Electrosurgical Procedure
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Kim Yun-Young
Chae Yong-Hwa
An Gye-Hyeong
Woo Jang-Hwan
Choi June-Seek
Kim Min-Hyoung
Ryu Hyun-Mee
Choi Kyu-Hong
Han Joung-Yeol
Lee Si-Won
Ahn Hyun-Kyong
Yang Jae-Hyug
Kim Moon-Young
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Abstract
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Objective: In this study, we evaluated whether different methods of conization of the cervix were associated with an increased risk of adverse pregnancy outcomes in subsequent pregnancy.
Methods: A retrospective case-control study was conducted. The study group included women who had undergone cold knife conization (n=170) or a loop electrosurgical excision procedure (LEEP) (n=86) and then had subsequent singleton pregnancies. The control group (n=497) included women with no history of cervical surgery. The outcomes were spontaneous preterm delivery and various neonatal outcomes such as low birth weight (LBW) and perinatal mortality.
Results: Cold knife conization was associated with a significantly increased risk of preterm delivery less than 34 weeks (relative risk 4.9, 95% confidence interval 1.6-15.1), preterm delivery less than 28 weeks (7.6, 15-39.6), LBW (2.6, 1.2-5.8), and perinatal mortality (11.9, 1.3-107.6). LEEP was not associated with a increased risk of adverse pregnancy outcomes.
Conclusion: Cold knife cone biopsy, but not LEEP of the cervix, is associated with an increased risk of preterm delivery less than 34 weeks of gestation and adverse neonatal outcomes. Clinicians counsel women appropriately before conservative treatment of cervical intraepithelial lesions.
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KEYWORD
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Premature birth, Cervix, Cold knife conization, LEEP
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