Guo H J, Guo R X, Liu Y L
Department of Obstetrics and Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Eur J Gynaecol Oncol. 2013;34(1):79-82.
To explore the effects of cervical loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC) on pregnancy outcomes.
Patients with cervical intraepithelial neoplasia (CIN) who wanted to become pregnant and received LEEP or CKC were considered as the treatment groups. Women who wanted to become pregnant and only underwent colposcopic biopsy without any treatments were considered as the control group. The pregnancy outcomes were observed and compared in the three groups.
Premature delivery rate was higher (p = 0.048) in the CKC group (14/36, 38.88%) than in control group (14/68, 20.5%) with a odds ratio (OR) of 2.455 (1.007 - 5.985); and premature delivery was related to cone depth, OR was significantly increased when the cone depth was more than 15 mm. There was no significant difference in premature delivery between LEEP (10 / 48, 20.83%) and the control groups. The average gestational weeks were shorter (p = 0.049) in the CKC group (36.9 +/- 2.4) than in the control group (37.8 +/- 2.6), but similar in LEEP (38.1 +/- 2.4) and control groups. There were no significant differences in cesarean sections between the three groups. The ratio of neonatal birth weight less than 2,500 g was significantly higher (p = 0.005) in the CKC group (15/36) than in the control group (10/68), but similar in the LEEP and control groups.
Compared with CKC, LEEP is relatively safe. LEEP should be a priority in the treatment of patients with CIN who want to become pregnant.
探讨宫颈环形电切术(LEEP)或冷刀锥切术(CKC)对妊娠结局的影响。
将希望妊娠且接受了LEEP或CKC治疗的宫颈上皮内瘤变(CIN)患者作为治疗组。将希望妊娠且仅接受了阴道镜活检而未接受任何治疗的女性作为对照组。观察并比较三组的妊娠结局。
CKC组(14/36,38.88%)的早产率高于对照组(14/68,20.5%)(p = 0.048),优势比(OR)为2.455(1.007 - 5.985);早产与锥切深度有关,当锥切深度超过15 mm时,OR显著增加。LEEP组(10 / 48,20.83%)与对照组的早产率无显著差异。CKC组(36.9 +/- 2.4)的平均孕周短于对照组(37.8 +/- 2.6)(p = 0.049),但LEEP组(38.1 +/- 2.4)与对照组相似。三组的剖宫产率无显著差异。CKC组(15/36)新生儿出生体重小于2500 g的比例显著高于对照组(10/68)(p = 0.005),但LEEP组与对照组相似。
与CKC相比,LEEP相对安全。对于希望妊娠的CIN患者,LEEP应作为首选治疗方法。