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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