The Outcome of Pregnancy After Cone Biopsy of the Cervix: A Case‐control Study

Jones, Jane M.; Sweetnam, P. M.; Hibbard, Bryan M.

doi:10.1111/j.1471-0528.1979.tb11237.x

Cited by 100 publications

(34 citation statements)

References 2 publications

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“…31,38 Only a small number of studies, using an external comparison group, examined the risk of preterm birth associated with spontaneous preterm birth. 11,13,26,36,38 The finding was consistent with that of all preterm birth. The risk associated with more severe outcomes such as extreme prematurity and perinatal morbidity and mortality was not included in this review because of the small number of studies using comparison groups other than an external comparison group; this question has been addressed by another recent review.…”

Section: Discussionsupporting

confidence: 80%

“…When studies examining preterm birth subtypes; preterm prelabour rupture of membranes (pPROM) and spontaneous preterm birth were analysed, the pattern for spontaneous preterm birth, with a pooled relative risk of 1.99 (95% CI 1.68-2.36), 11,13,26,36,38 was similar to that of all preterm birth using an external comparison group. The estimate for the risk of preterm prelabour rupture of membranes was higher, with a wider confidence interval (pooled RR 3.40, 95% CI 1.63-8.11).…”

Section: Association Of Excisional Methods Of Treatment and Preterm Bmentioning

confidence: 99%

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The risk of preterm birth following treatment for precancerous changes in the cervix: a systematic review and meta-analysis

Bruinsma

Quinn

2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

201

145

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Background Studies investigating the association between treatment for precancerous changes in the cervix and risk of preterm birth have used a variety of comparison groups.Objectives To investigate whether treatment for precancerous changes in the cervix is associated with preterm birth (<37 weeks) and to examine the impact of the type of comparison group on estimates of risk.Search strategy PubMed, Embase and CENTRAL were searched for studies pubished between 1950 and 2009.Selection criteria Eligible studies were those that reported preterm birth outcomes for excisional and ablative treatments separately and included a comparison group.Data collection and analysis Pooled relative risks (RR) and 95% confidence intervals were computed using a random effects model.Main results Thirty eligible studies were located. Excisional treatment was associated with an increased odds of preterm birth, when compared with an external (RR 2.19, 95% CI 1.93-2.49) or internal (RR 1.96, 95% CI 1.46-2.64) comparison group. In comparison with women who were assessed but not treated, the risk estimate was smaller (RR 1.25, 95% CI 0.98-1.58). Ablative treatment was associated with an increased risk of preterm birth when an external comparison group (RR 1.47, 95% CI 1.24-1.74) but not an internal comparison group (RR 1.24, 95% CI 0.73-2.10) or untreated comparison group (RR 1.03, 95% CI 0.90-1.18) was used.

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Section: Discussionsupporting

confidence: 80%

Section: Association Of Excisional Methods Of Treatment and Preterm Bmentioning

confidence: 99%

The risk of preterm birth following treatment for precancerous changes in the cervix: a systematic review and meta-analysis

Bruinsma

Quinn

2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

201

145

View full text Add to dashboard Cite

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“…Early study results show that conization does not constitute a hazard to the outcome of future pregnancies. [8][9][10] However, recent studies have reported that conization can lead to impaired outcomes of pregnancy. [11][12][13] The incidence of preterm deliveries following conization varies in recent publications between 14 and 25%.…”

Section: Discussionmentioning

confidence: 99%

The role of prophylactic cerclage in preventing preterm delivery after electrosurgical conization

et al. 2010

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Objective: To evaluate pregnancy outcomes after electrosurgical conization. Methods: We retrospectively analyzed the outcomes of 56 singleton pregnancies after electrosurgical conization of the uterine cervix. Of the 56 cases, 25 women underwent prophylactic cerclage with McDonald procedure (cerclage group), and 31 were managed expectantly (expectant group). Pregnancy outcomes including rate of preterm delivery were compared, and the effect of potential risk factors such as depth of cone, interval between conization and pregnancy, and cervical length on the risk of preterm delivery was assessed. Results: The rate of preterm delivery was significantly higher in women with a history of electrosurgical conization than those without (32.1% vs. 15.2%, p＜0.001). However, preterm delivery rate was not different between the two groups (expectant group vs. cerclage group; ＜28 week, 6.5% vs. 8.0%, p=1.000; ＜34 week, 19.4% vs. 20.0%, p=1.000; ＜37 week, 29.0% vs. 36.0%, p=0.579). All obstetric and neonatal outcomes were similar in the two groups. Even when we confined the study subjects to 19 women (19/56, 33.9%) with cervical length less than 25 mm, the preterm delivery rate also was not significantly different between the expectant (n=7) and cerclage group (n=12). Finally, the potential risk factors for preterm delivery were not associated with risk of preterm delivery in patients with a history of electrosurgical conization. Conclusion:The rate of preterm delivery was significantly higher in women with a history of electrosurgical conization before pregnancy. However, prophylactic cervical cerclage did not prevent preterm delivery in these patients.

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“…Cervical conization, however, is not without significant risk and has been associated with cervical stenosis (13), as well as poor obstetric outcomes. Subsequent pregnancies are at risk of second-trimester pregnancy loss and incompetent cervix (14,15), preterm labor (14), PPROM (16), and preterm delivery (14,(17)(18)(19)(20). Despite the common use of less radical excision procedures, the risk of adverse pregnancy outcomes has been linked, in a number of studies, to LEEP procedures (16,19,21).…”

Section: Discussionmentioning

confidence: 99%

Management of Cervical Intraepithelial Neoplasia 2 in Adolescent and Young Women

Fuchs¹,

Weitzen²,

Wu³

et al. 2007

Journal of Pediatric and Adolescent Gynecology

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Study Objective-To evaluate regression rates among adolescents (aged ≤21) with CIN 2 managed expectantly and to determine factors associated with disease regression.Design-Cohort study using a colposcopic database of 2,996 women seen between August 1999 and November 2005Setting-Colposcopy clinic in urban, tertiary care medical center Participants-Adolescents with CIN 2. Routine management consisted of two options: immediate treatment or repeat colposcopic evaluation in 6 months.Main Outcome Measures-For those managed conservatively, regression was defined either as a subsequent normal colposcopy and/or biopsy and at least 2 smears read as negative for epithelial abnormality or at least 3 consecutive negative smears if repeat colposcopy was not performed. Demographic information, including age, was assessed to determine possible associations with disease regression.Results-Of the 93 adolescents, 53 (57%) elected to undergo immediate treatment with a diagnostic excisional procedure, and 40 (43%) chose management with colposcopic follow-up. Of those treated, high-grade disease (CIN 2+) was found in 40 (75%). Of the 36 young women followed conservatively (4 were lost to follow-up), regression after a median follow-up time of 378 days was documented in 14 (39%). Of the 22 adolescents not fulfilling our criteria for regression, only 3 had evidence of CIN 2 or worse during follow-up. The remaining 19 had either CIN 1 or mildly abnormal cytologic results. Kaplan-Meier survival estimates indicated younger age (≤16 years) tended to be associated with decreased time to regression. Conclusion-Based on significant regression of CIN 2 among adolescent women, primary management in this population should consist of cytologic and colposcopic follow-up.

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The Outcome of Pregnancy After Cone Biopsy of the Cervix: A Case‐control Study

Cited by 100 publications

References 2 publications

The risk of preterm birth following treatment for precancerous changes in the cervix: a systematic review and meta-analysis

The risk of preterm birth following treatment for precancerous changes in the cervix: a systematic review and meta-analysis

The role of prophylactic cerclage in preventing preterm delivery after electrosurgical conization

Management of Cervical Intraepithelial Neoplasia 2 in Adolescent and Young Women

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