Pregnancy Outcome after the Treatment of Loop Electrosurgical Excision Procedure or Cold-Knife Conization for Cervical Intraepithelial Neoplasia

Liu, Yi; Qiu, Hai Fan; Tang, Yunbing; Chen, Jie; Lv, Jieqiang

doi:10.1159/000360538

Cited by 33 publications

(18 citation statements)

References 18 publications

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“…Our study found that a prior cervical excision procedure was associated with an increased risk of forceps delivery(p = 0.034), and the main purpose of forceps delivery was to shorten the second stage of labor(p = 0.033). The cervix, which is consisted of smooth muscle, broblasts, epithelium, and blood vessels, is considered to play an important role in delivery [15,16]. Theoretically, cervical excision procedure has an impact on the structure and function of the uterus, which may affect the process of labor.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Impact of Cervical Excision Procedure on Delivery Mode

YUAN

ZHANG

et al. 2020

Preprint

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Background: Many young women with a history of prior cervical excision procedure have reproductive intention. However, the relationship between having a prior cervical excision procedure and delivery mode has not drawn enough attention from physicians. The aim of this study was to observe the delivery mode of women with a prior cervical excision procedure, and analyze the relationship between having a prior cervical excision procedure and delivery mode.Methods: In this retrospective cohort study of nulliparous women with a singleton pregnancy who have given birth at Beijing Obstetrics and Gynecology Hospital, Capital Medical University between May 2016 and April 2018, delivery mode of women with a history of prior cervical excision procedure were compared with those without such a history. Bivariable analysis were performed to identify whether there was a correlation between having a prior cervical excision procedure and delivery mode, and logistic regression were used modeling on cervical excision procedure for delivery mode outcome.Results: (1) The proportion of premature rupture of fetal membrane (38.3% vs 27.0%, p=0.034) , forceps delivery (12.2% vs 5.9%, p=0.043), and Caesarean sections delivery (33.9% vs. 30.2%,p=0.484 ) were higher among women with a prior cervical excision procedure. (2) The main indication for forceps delivery was to shorten the second stage of labor among women with a prior cervical excision procedure, significantly higher (50% vs 7.7%, p=0.033) among women without such a history. There were no differences in indications for Caesarean sections delivery in two groups (p>0.05). (3) The time interval between cervical excision procedure and pregnancy was not associated with delivery mode (p=0.445). (4) By setting spontaneous labor as control, forceps delivery was associated with cervical excision procedure (OR=0.403, 95%CI=0.179-0.906, p=0.028).Conclusions: Our findings revealed a relationship between having a prior cervical excision procedure and delivery mode. Women with a prior cervical excision procedure were at an increased risk of forceps delivery. The time interval between cervical excision procedure and pregnancy did not affect delivery mode.

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Section: Discussionmentioning

confidence: 99%

Analysis of the Impact of Cervical Excision Procedure on Delivery Mode

YUAN

ZHANG

et al. 2020

Preprint

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“…Based on previously reported cases, primary DLBCL of the female genital tract can occur at any age. With the introduction of immunochemotherapy, we could hope for a promising result regarding disease-free survival, but this introduces another important challenge - how to preserve the childbearing potential [1,18,19]. There are only limited data on the recommended time of contraception, the risk of miscarriages or the pregnancy outcome of women with and after R-CHOP immunochemotherapy in primary NHL of the female genital tract [1,18,19].…”

Section: Discussionmentioning

confidence: 99%

Incidentally Discovered Diffuse Large B-Cell Lymphoma Limited to the Endocervical Mucosa in a Young Female Patient

Pósfai¹,

Nagy²,

Marton³

et al. 2015

Gynecol Obstet Invest

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Primary high-grade non-Hodgkin lymphoma of the female genital tract is extremely rare. Vaginal bleeding, abdominal pain or urinary complaints might be its most frequent symptoms. We report a 27-year-old multipara who underwent large loop excision of the transformation zone because of the repeated finding of a low-grade squamous intraepithelial lesion identified during routine cancer screening. Incidentally, CD20-positive, primary, diffuse large B-cell lymphoma infiltrating the mucosa of the endocervix was also diagnosed from this specimen. The case is unusual because the patient had no symptoms, specific colposcopic signs or visible mass. R-CHOP 21 immunochemotherapy was introduced and resulted in complete remission without hysterectomy. The patient is without any evidence of disease after 49 months of follow-up. Primary cervical lymphomas are mainly subepithelial initially, and therefore they may be under-recognized due to the inefficiency of smears to diagnose such lesions. Early diagnosis and available targeted treatment allowed a cure in the reported example.

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“…Invasive cervical cancer is the second most common cancer in women, with an estimated 529,000 new cases and 274,000 deaths each year [1,2]. It is a serious threat to women's quality of health and life.…”

Section: Introductionmentioning

confidence: 99%

Can Genomic Amplification of Human Telomerase Gene and C-MYC in Liquid-Based Cytological Specimens Be Used as a Method for Opportunistic Cervical Cancer Screening?

Gao¹,

Eurasian²,

Zhang³

et al. 2015

Gynecol Obstet Invest

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Objective: To evaluate the effectiveness of five methods including the ThinPrep cytological test (TCT), liquid-based cytology, the human papillomavirus (HPV) test, detection of the TERC and C-MYC genes and visual inspection with acetic acid/Lugol's iodine (VIA/VILI) for opportunistic cervical cancer screening, and to explore whether genomic amplification of the human telomerase gene and C-MYC in liquid-based cytological specimens can be used as a method for opportunistic cervical cancer screening. Methods: Data were collected prospectively from 1,010 consecutive patients who visited the gynecology clinic and agreed to participate in opportunistic cervical cancer screening at our institution from November 2010 to July 2011. The five methods mentioned above were used for the screening in all cases. The histopathological diagnosis served as the gold standard for the evaluation. A comparison between the five screening methods for the diagnosis of high-grade cervical intraepithelial neoplasia (CIN II and III) was performed for their sensitivity, specificity, false-positive rate, false-negative rate, accuracy rate, positive likelihood ratio and negative likelihood ratio. A comprehensive comparison of the different combination programsfor screening was performed according to the analysis of the receiver operating characteristic (ROC) curve area. The accuracy of the five screening methods for the diagnosis of high-grade CIN (CIN II and III) was compared in the different age groups. A joint model for the diagnosis using different combinations of the five methods was developed according to the analysis by the SAS 8.0 software. The model was used to evaluate the accuracy of the different combination programs for the diagnosis of high-grade CIN, and the results were confirmed by the histopathological examination. Results: The sensitivity and specificity of the single screen method (TCT, HPV test, detection of the TERC and C-MYC genes, and VIA/VILI method) for CIN II was 80.9, 70.2, 72.3, 76.6, and 72.3%, as well as 98.0, 95.1, 96.3, 96.3, and 90.4%, respectively. The sensitivity of the single screening method in four different age groups (25-34, 35-44, 45-54 and 55-66 years) was as follows: TCT, 64.3, 90.9 76.5, and 85.7%; HPV test, 78.6, 72.7, 60.0, and 71.4%; the TERC gene, 50.0, 90.9, 80.0, and 71.4%; the C-MYC gene, 50.0, 90.9, 80.0, and 100%; VIA/VILI, 85.7, 81.8, 66.7, and 42.9%. The specificity was: TCT, 98.9, 98.1, 98.8, and 95.2%; HPV test, 96.7, 95.1, 92.2, and 100%; the TERC gene, 95.0, 98.9, 94.0, and 95.2%; the C-MYC gene, 97.2, 97.3, 93.4, and 97.6%; VIA/VILI, 91.2, 90.5, 89.8, and 88.1%, respectively. In the joint model for the diagnosis using different combinations, we found Logit (P) = 5.757 - 4.055 × TCT - 3.724 × HPV. The sensitivity and specificity in the combination program with TCT (primary screening) and HPV testing (adjunct screening) were 78.7 and 99.5%, while in the combination with HPV (primary) and TCT (adjunct), they were 53.2 and 99.7%, respectively. However, in the cytology-HPV parallel test, t...

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Pregnancy Outcome after the Treatment of Loop Electrosurgical Excision Procedure or Cold-Knife Conization for Cervical Intraepithelial Neoplasia

Cited by 33 publications

References 18 publications

Analysis of the Impact of Cervical Excision Procedure on Delivery Mode

Analysis of the Impact of Cervical Excision Procedure on Delivery Mode

Incidentally Discovered Diffuse Large B-Cell Lymphoma Limited to the Endocervical Mucosa in a Young Female Patient

Can Genomic Amplification of Human Telomerase Gene and C-MYC in Liquid-Based Cytological Specimens Be Used as a Method for Opportunistic Cervical Cancer Screening?

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