Cruickshank M E, Flannelly G, Campbell D M, Kitchener H C
Wellbeing Centre for the Prevention of Cervical Cancer, Department of Obstetrics and Gynaecology, Aberdeen.
Br J Obstet Gynaecol. 1995 Jun;102(6):467-70. doi: 10.1111/j.1471-0528.1995.tb11319.x.
To determine if large loop excision of the transformation zone affects subsequent fertility and pregnancy outcome.
A case-control study.
A teaching hospital serving a regional population.
One thousand women who had undergone large loop excision of the transformation zone (LLETZ) for the treatment of cervical intraepithelial neoplasia (CIN) between 1989 and 1991. Two controls were matched for each of the 149 women who had a singleton pregnancy progressing beyond 20 weeks of gestation following treatment, with regard to age, parity, height, husband's or partner's social class and smoking habits to account for common independent risk factors for adverse obstetric outcome and cervical intraepithelial neoplasia.
Intention to conceive, number of pregnancies, gestation, low birthweight, mean birthweight, mode of delivery, and duration of labour.
Out of a cohort of 1000 women who underwent LLETZ for the treatment of CIN, 653 women replied to a postal questionnaire. When asked up to 54 months after treatment, 130 women (19.9%) had become pregnant and 47 (7.2%) had tried to become pregnant. A total of 199 pregnancies from 178 women was identified from the cohort of women. For the 149 women from the case cohort, the mean birthweight was 3380 g compared with 3373 g in the control group (P = 0.88). The incidence of low birthweights in pregnancies progressing to at least 37 weeks of gestation was 3.1% in the treated group, compared with 3.2% in the control group (P = 0.98). Following LLETZ, 9.4% of deliveries were preterm (< 37 weeks of gestation), compared with 5.0% in the control group (p = 0.12). There was no significant difference in mean gestation, mode of delivery, indication for caesarean section or duration of labour between the women who had undergone LLETZ and the controls.
When socio-epidemiological factors associated with the development of cervical intraepithelial neoplasia are controlled for, LLETZ does not appear to exert an independent adverse effect on subsequent pregnancy outcome.
确定转化区大环形切除术是否会影响后续生育能力及妊娠结局。
病例对照研究。
为区域人口服务的教学医院。
1989年至1991年间因治疗宫颈上皮内瘤变（CIN）而接受转化区大环形切除术（LLETZ）的1000名女性。对于治疗后单胎妊娠进展至妊娠20周以上的149名女性中的每一位，匹配两名对照，在年龄、产次、身高、丈夫或伴侣的社会阶层以及吸烟习惯方面进行匹配，以考虑不良产科结局和宫颈上皮内瘤变的常见独立危险因素。
受孕意愿、妊娠次数、妊娠孕周、低出生体重、平均出生体重、分娩方式及产程。
在接受LLETZ治疗CIN的1000名女性队列中，653名女性回复了邮寄问卷。在治疗后长达54个月时询问，130名女性（19.9%）已怀孕，47名女性（7.2%）曾尝试怀孕。从该女性队列中识别出178名女性的199次妊娠。病例队列中的149名女性，平均出生体重为3380克，对照组为3373克（P = 0.88）。妊娠进展至至少37周的低出生体重发生率，治疗组为3.1%，对照组为3.2%（P = 0.98）。LLETZ术后，9.4%的分娩为早产（<37周妊娠），对照组为5.0%（p = 0.12）。接受LLETZ治疗的女性与对照组在平均妊娠孕周、分娩方式、剖宫产指征或产程方面无显著差异。
当控制与宫颈上皮内瘤变发生相关的社会流行病学因素时，LLETZ似乎不会对后续妊娠结局产生独立的不良影响。
