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冷刀锥切术对宫颈病变患者妊娠结局的影响。

The effect of cold-knife conization on pregnancy outcomes in patients with cervical lesions.

机构信息

Department of Gynecology, Dalian Women and Children's Medical Group, Dalian, Liaoning, People's Republic of China.

出版信息

PLoS One. 2022 Dec 1;17(12):e0278505. doi: 10.1371/journal.pone.0278505. eCollection 2022.

Abstract

OBJECTIVE

To analyze the pregnancy outcomes of patients with cervical lesions treated by cold-knife conization (CKC).

METHODS

Clinical data of healthy pregnant women and pregnant women who underwent CKC in Dalian Women and Children's Medical Group from March 2010 to December 2019 were retrospectively analyzed. These patients were divided into a CKC group and a control group according to inclusion and exclusion criteria. Statistical methods were used to compare pregnancy and delivery outcomes between the two groups.

RESULTS

There were 400 patients in CKC group and control group, with 200 patients in each. There was no significant difference in the mode of delivery, abortion, ectopic pregnancy, in-hospital perinatal management, and cervical cerclage between the CKC group and the control group (P>0.05). The rates of preterm delivery, premature rupture of membranes, cesarean section, and neonatal admission in the CKC group were higher than those in the control group (P<0.05). In the CKC group, the incidence of premature rupture of membranes within six months postoperatively was higher than that after six months (P<0.05). The incidences of preterm delivery and premature rupture of membranes were not completely consistent in different conization ranges (P<0.05).

CONCLUSION

CKC increases the incidence of preterm delivery, premature rupture of membranes, and neonatal adverse outcomes. Conization height can predict the occurrence of preterm delivery. Delaying pregnancy after surgery can reduce the incidence of adverse outcomes during the perinatal period.

摘要

目的

分析冷刀锥切术(CKC)治疗宫颈病变患者的妊娠结局。

方法

回顾性分析 2010 年 3 月至 2019 年 12 月大连妇女儿童医疗中心收治的健康孕妇和接受 CKC 的孕妇的临床资料。根据纳入和排除标准,将这些患者分为 CKC 组和对照组。采用统计学方法比较两组患者的妊娠结局。

结果

CKC 组和对照组各有 400 例患者,每组 200 例。两组患者的分娩方式、流产、异位妊娠、住院围产管理和宫颈环扎术比较,差异无统计学意义(P>0.05)。CKC 组患者早产、胎膜早破、剖宫产和新生儿入院率均高于对照组(P<0.05)。CKC 组术后 6 个月内胎膜早破的发生率高于术后 6 个月(P<0.05)。不同锥切范围的早产和胎膜早破发生率不完全一致(P<0.05)。

结论

CKC 增加了早产、胎膜早破和新生儿不良结局的发生率。锥切高度可预测早产的发生。术后延迟妊娠可降低围产期不良结局的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf71/9714936/1e81d81f56e1/pone.0278505.g001.jpg

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