Pregnancy outcome after laser vaporization of the cervix

Rooijen, MarianneVan; Persson, Elisabeth

doi:10.1080/j.1600-0412.1999.780414.x

Cited by 18 publications

(6 citation statements)

References 6 publications

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“…When the different types of treatment were compared, cone biopsy, diathermy and LEEP (but not laser ablation) appeared to place women at increased risk for preterm birth. The findings of smaller studies 14,32–34 and a systematic review 12 support our finding that laser ablation does not appear to place treated women at an additional risk for preterm birth compared with untreated women.…”

Section: Commentsupporting

confidence: 64%

Precancerous changes in the cervix and risk of subsequent preterm birth

Bruinsma

Lumley

Tan

et al. 2006

BJOG

108

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Objective The aims of this study were (i) to examine whether women referred for assessment of precancerous changes in the cervix had higher rates of preterm birth compared with those in the general population and (ii) to compare preterm birth rates for treated and untreated women adjusting for possible confounding factors.Design Retrospective cohort design. Setting Teaching hospital.Population All women referred to the Royal Women's Hospital, Melbourne (1982Melbourne ( -2000, who subsequently had a birth recorded on the Victorian Perinatal Data Collection system (n = 5548).Methods Record linkage of hospital dysplasia clinic records and population-based birth records.Main outcome measures Total preterm delivery (<37 weeks of gestation) and subtypes.Results Both treated and untreated women were at a significantly increased risk for preterm birth compared with those in the general population: treated-standardised prevalence ratio (SPR) 2.0, 95% CI 1.8-2.3 and untreated-SPR 1.5, 95% CI 1.4-1.7. Within the cohort, the treated women were significantly more likely to give birth preterm (adjusted OR 1.23, 95% CI 1.01-1.51). An increased risk of preterm birth was also associated with a history of induced or spontaneous abortions, illicit drug use during pregnancy or a major maternal medical condition. Cone biopsy, loop electrosurgical excision procedure and diathermy were associated with preterm birth. After adjusting for possible confounding factors, only diathermy remained significant (adjusted OR 1.72, 95% CI 1.36-2.17). Women treated using laser ablation were not at an increased risk for preterm birth (adjusted OR 1.1, 95% CI 0.8-1.4).Conclusions Diagnosis of precancerous changes in the cervix (regardless of the treatment) was associated with an increased risk of preterm birth. Consideration should be given to the preferential use of ablative treatments.

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Section: Commentsupporting

confidence: 64%

Precancerous changes in the cervix and risk of subsequent preterm birth

Bruinsma

Lumley

Tan

et al. 2006

BJOG

108

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“…There may be differences in perinatal outcome by different surgical treatments for CIN. While ablative treatments do not seem to affect subsequent pregnancies (5–9), there may be an adverse perinatal outcome with an increased risk of preterm birth after LEEP and CLC. Mechanisms proposed include lack of mechanical support due to shortened length of the cervix, impairment of antimicrobial defence mechanisms after removal of cervical glands, and, thereby, alteration of cervicovaginal bacterial flora.…”

Section: Discussionmentioning

confidence: 99%

“…Treatments for CIN may affect the outcome of later pregnancies, although data on this are contradictory. While ablative treatments do not seem to have an adverse effect (5–9), results on pregnancy outcome after loop electrosurgical excision procedure (LEEP) and cervical laser conisation (CLC) are conflicting (10–15). The main difference between ablative and excisional methods is removal of cervical tissue, and, thereby, the extent of tissue damage.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcome after cervical cone excision: a case‐control study

Sjøborg

Vistad

Myhr

et al. 2007

Acta Obstet Gynecol Scand

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“…Several publications in recent years describe an association between the outcome of pregnancy and preterm delivery after conization of the cervix (87–90). Most studies have been conducted using the cold knife technique (88).…”

Section: Conization Of the Cervix And Preterm Labormentioning

confidence: 99%

Preterm delivery: an overview

Haram¹,

Mortensen²,

Wollen³

2003

Acta Obstet Gynecol Scand

121

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Preterm delivery is the leading factor causing neonatal mortality and morbidity. We have conducted a PubMed literature search to obtain an update on the etiology, diagnostic problems and therapeutic considerations of preterm delivery. Approximately 5-10% of all births are premature. Preterm labor is associated with preterm rupture of membranes, cervical incompetence, polyhydramnion, fetal and uterine anomalies, infections, social factors, stress, smoking, heavy work and other risk factors. The diagnosis is made on the patients presenting symptoms, clinical findings and of progressive effacement and dilatation of the cervix. Biochemical markers of preterm delivery are of minor importance in daily clinical work. Measurement of the cervix, however, is a practical and valuable tool to predict preterm delivery. Cervical cerclage can be useful in selected cases. Antibiotics may help to prevent preterm labor in cases of known etiologic agents (e.g. preterm rupture of membranes and urinary infection). The use of tocolytic agents such as beta-sympathetic receptor stimulators can be advocated for a few days. There is evidence that their long-term use is not beneficial and could even be harmful to the fetus. Calcium channel blockers (nifedipine) and a new selective oxytocin receptor antagonist, atosiban, appear to be as effective as beta-sympathomimetic drugs on uterine contractions with fewer side-effects. Prostaglandin synthetase inhibitors such as indomethacin may prevent uterine contractions and can be used prior to the 32nd week of pregnancy. A single course of corticosteroid treatment in two doses of 12 mg betamethasone or 6 mg of dexamethasone is important for the prevention of respiratory distress between the 24th and 34th weeks of pregnancy. Multiple doses may be harmful and should be avoided. In these cases management should depend on gestation age (fetal maturity). Uterine contractions after 34 weeks' gestation are not an indication for tocolytic treatment.

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Pregnancy outcome after laser vaporization of the cervix

Abstract: Laser vaporization of the uterine cervix does not influence the outcome of subsequent pregnancy.

Cited by 18 publications

References 6 publications

Precancerous changes in the cervix and risk of subsequent preterm birth

Precancerous changes in the cervix and risk of subsequent preterm birth

Pregnancy outcome after cervical cone excision: a case‐control study

Preterm delivery: an overview

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