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宫颈锥切术对生育能力及妊娠结局影响的临床分析

[Clinical analysis of the effect of cervical conization on fertility and pregnancy outcome].

作者信息

He Hao-jie, Pan Ling-ya, Huang Hui-fang, Lang Jing-he

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2007 Aug;42(8):515-7.

Abstract

OBJECTIVE

To evaluate the effect of conization for cervical intraepithelial neoplasia on the outcome of subsequent fertility and pregnancy.

METHODS

A retrospective study was performed of patients who underwent conization from 1999 to 2005 in Peking Union Medical College Hospital. The nullipara patients below 40-years old without primary or secondary infertility were followed up.

RESULTS

Thirty-five patients aged from 23 to 40 years, who had pregnancy desire, were included in the study. The mean age of patients was 31 years. Twenty-five women with 26 pregnancies were identified among the 35 patients, and the pregnancy rate was 74% (26/35), which was not significantly different from that of the same patients before conization (69%, P > 0.05). Among the 26 pregnancies, there occurred one ectopic pregnancy and four cases of spontaneous abortion. In the 13 delivery cases, there were one premature delivery, two cases of premature rupture of the membrane, and ten cases of cesarean section. The sample height of the cone was less than 2.0 cm in the nine delivery cases, and the mean width of the cone was over 2.5 cm.

CONCLUSION

No evidence of secondary infertility caused by cervical conization was found. There was also no significant increase in the number of either premature delivery cases or low birth weight infants. The sample height of the cone might play a more important role in the pregnancy outcome than the width, which still needs to be further verified by larger studies.

摘要

目的

评估宫颈上皮内瘤变锥切术对后续生育及妊娠结局的影响。

方法

对1999年至2005年在北京协和医院接受锥切术的患者进行回顾性研究。对年龄在40岁以下、无原发性或继发性不孕的未孕患者进行随访。

结果

35例有妊娠意愿、年龄在23至40岁的患者纳入研究。患者平均年龄为31岁。35例患者中,25名女性有26次妊娠,妊娠率为74%(26/35),与锥切术前相同患者的妊娠率(69%)相比,差异无统计学意义(P>0.05)。26次妊娠中,发生1例异位妊娠和4例自然流产。13例分娩病例中,有1例早产、2例胎膜早破和10例剖宫产。9例分娩病例中锥切标本高度小于2.0 cm,锥切标本平均宽度超过2.5 cm。

结论

未发现宫颈锥切术导致继发性不孕的证据。早产病例数或低体重儿数量也未显著增加。锥切标本高度可能比宽度对妊娠结局的影响更大,这仍需更大规模的研究进一步验证。

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