Sato Yuka, Hidaka Nobuhiro, Sakai Atsuhiko, Kido Saki, Fujita Yasuyuki, Okugawa Kaoru, Yahata Hideaki, Kato Kiyoko
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Obstetrics, Fukuoka Children's Hospital, Fukuoka, Japan.
Eur J Obstet Gynecol Reprod Biol. 2021 Apr;259:119-124. doi: 10.1016/j.ejogrb.2021.02.009. Epub 2021 Feb 13.
To determine whether vaginal progesterone (VP) reduces the rate of preterm birth in pregnant women after abdominal trachelectomy (AT) for early-stage cervical cancer STUDY DESIGN: This is an interventional study with a historical cohort. For the interventional study participants who had singleton pregnancies after AT between October 2016 and September 2020, the administration of vaginal progesterone was started between 16 and 19 weeks of gestation and discontinued at 34 weeks of gestation or at the time of delivery, rupture of membranes, or massive uterine bleeding. We investigated obstetric and neonatal outcomes among the study participants and compared them with outcomes of the historical control group participants, included women with singleton pregnancies after AT who were managed without VP at our institution between January 2007 and September 2016, using Fisher's exact test and the Mann-Whitney U test The main outcomes were the gestational age at delivery and incidence of preterm birth before 37 weeks and 34 weeks of gestation.
Twelve pregnancies in ten women were included in the VP group. In contrast, 19 pregnancies in 17 women were included in the historical control group. The incidence of preterm birth at <37 weeks was 10/12 (83 %) in the VP group and 11/19 (58 %) in the control group. The incidence of preterm birth at <34 weeks was 6/12 (50 %) in the VP group and 9/19 (48 %) in the control group. The incidence of preterm birth in the two groups was similar, and the difference between the two groups was not statistically significant.
The administration of vaginal progesterone did not reduce the rate of preterm birth among pregnant women after AT.
确定阴道用黄体酮（VP）是否能降低早期宫颈癌腹式宫颈切除术（AT）后孕妇的早产率。
这是一项采用历史性队列的干预性研究。对于2016年10月至2020年9月期间接受AT后单胎妊娠的干预性研究参与者，在妊娠16至19周开始给予阴道用黄体酮，并在妊娠34周或分娩、胎膜破裂或大量子宫出血时停用。我们调查了研究参与者的产科和新生儿结局，并将其与历史性对照组参与者的结局进行比较，历史性对照组包括2007年1月至2016年9月期间在我们机构接受AT后单胎妊娠且未使用VP治疗的女性，采用Fisher精确检验和Mann-Whitney U检验。主要结局为分娩时的孕周以及妊娠37周和34周前的早产发生率。
VP组纳入了10名女性的12次妊娠。相比之下，历史性对照组纳入了17名女性的19次妊娠。VP组<37周的早产发生率为10/12（83%），对照组为11/19（58%）。VP组<34周的早产发生率为6/12（50%），对照组为9/19（48%）。两组的早产发生率相似，两组之间的差异无统计学意义。
阴道用黄体酮给药并未降低AT后孕妇的早产率。
