Resident.
Professor.
Obstet Gynecol Surv. 2017 Aug;72(8):494-499. doi: 10.1097/OGX.0000000000000468.
Conservative excisional measures used to manage cervical dysplasia are often cited as risk factors for preterm labor in subsequent pregnancies.
We performed an evidence-based review of the obstetric complications following excisional procedures for cervical dysplasia in women of reproductive age.
Between 1993 and 2016, there were 7 published meta-analyses of cohort studies that consistently demonstrated an association between excisional cervical procedures and preterm labor. However, controversy remains as to whether the increased risk is due to the cervical amputation or to the risk factors that underlie the dysplasia.
Although data suggest an association between excisional procedures and preterm labor, the choice of the control group may either overestimate or underestimate the relative risk. In addition, recent data suggest that depth of excision greater than 10 to 12 mm is associated with increases in risk of preterm birth.
Women with cervical dysplasia are at an increased baseline risk of preterm birth, and surgical excision confers additional risk. Pregnant patients with advanced cervical dysplasia or a history of surgical excision should be considered high-risk pregnancies.
用于治疗宫颈发育不良的保守性切除术常被认为是随后妊娠早产的危险因素。
我们对育龄妇女宫颈发育不良切除术后的产科并发症进行了基于证据的综述。
1993 年至 2016 年，共有 7 项关于队列研究的荟萃分析发表，这些研究一致表明宫颈切除术与早产之间存在关联。然而，争议仍然存在，即增加的风险是由于宫颈切除还是潜在发育不良的危险因素。
尽管数据表明宫颈切除术与早产之间存在关联，但对照组的选择可能会高估或低估相对风险。此外，最近的数据表明，切除深度大于 10 至 12 毫米与早产风险增加相关。
患有宫颈发育不良的妇女早产的基线风险增加，手术切除会增加额外的风险。患有晚期宫颈发育不良或有手术切除史的孕妇应被视为高危妊娠。
