Article Data

  • Views 479
  • Dowloads 119

Original Research

Open Access

Effects of loop electrosurgical excision procedure or cold knife conization on pregnancy outcomes

  • H. J. Guo1
  • R. X. Guo1,*,
  • Y. L. Liu1

1Department of Obstetrics and Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou (China)

DOI: 10.12892/ejgo340115 Vol.34,Issue 1,January 2013 pp.79-82

Published: 10 January 2013

*Corresponding Author(s): R. X. Guo E-mail:


Purpose: To explore the effects of cervical loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC) on pregnancy outcomes. Materials and Methods: Patients with cervical intraepithelial neoplasia (CIN) who wanted to become pregnant and received LEEP or CKC were considered as the treatment groups. Women who wanted to become pregnant and only underwent colposcopic biopsy without any treatments were considered as the control group. The pregnancy outcomes were observed and compared in the three groups. Results: Premature delivery rate was higher (p = 0.048) in the CKC group (14 / 36, 38.88%) than in control group (14 / 68, 20.5%) with a odds ratio (OR) of 2.455 (1.007 - 5.985); and premature delivery was related to cone depth, OR was significantly increased when the cone depth was more than 15 mm. There was no significant difference in premature delivery between LEEP (10 / 48, 20.83%) and the control groups. The average gestational weeks were shorter (p = 0.049) in the CKC group (36.9 ± 2.4) than in the control group (37.8 ± 2.6), but similar in LEEP (38.1 ± 2.4) and control groups. There were no significant differences in cesarean sections between the three groups. The ratio of neonatal birth weight less than 2,500 g was significantly higher (p = 0.005) in the CKC group (15/36) than in the control group (10/68), but similar in the LEEP and control groups. Conclusion: Compared with CKC, LEEP is relatively safe. LEEP should be a priority in the treatment of patients with CIN who want to become pregnant.


Conization of cervix; Cervical loop electrosurgical excision procedure; Cervical cold knife conization; Cervical intraepithelial neoplasia; Pregnancy outcomes.

Cite and Share

H. J. Guo,R. X. Guo,Y. L. Liu. Effects of loop electrosurgical excision procedure or cold knife conization on pregnancy outcomes. European Journal of Gynaecological Oncology. 2013. 34(1);79-82.


[1] De-ying Qian, Ren-hai Zeng, Dan-hua Hong, Jian-min Cen: “Pregnancy and delivery outcomes after loop electrosurgical excision procedure of cervical intraepithelial neoplasia”. Chin. J. Obstet. Gynecol., 2004, 39, 326.

[2] Hao-jie He, Ling-ya Pan, Hui-fang Huang, Jing-he Lang: “Clinical analysis of the effect of cervical conization on fertility and pregnancy outcomes”. Chin. J. Obstet. Gynecol., 2007, 42, 515.

[3] Noehr B., Jensen A., Frederiksen K., Tabor A., Kjaer S.K.: “Depth of cervical cone removed by loop electrosurgical excision procedure and subsequent risk of spontaneous”. Preterm Delivery Obstet. Gynecol., 2009, 114, 1232.

[4] Arbyn M., Kyrgiou M., Simoens C., Raifu A.O., Koliopoulos G., Martin-Hirsch P. et al.: “Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis”. BMJ, 2008, 337, a1284.

[5] Sjøborg K.D., Vistad I., Myhr S.S., Svenningsen R., Herzog C., Kloster-Jensen A. et al.: “Pregnancy outcome after cervical cone excision: a case-control study”. Acta Obstet. Gynecol. Scand., 2007, 86, 423.

[6] Kyrgiou M., Koliopoulos G., Martin-Hirsch P., Arbyn M., Prendiville W., Paraskevaidis E.: “Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis”. Lancet, 2006, 367, 489.

[7] Xue-jie Zhu, Yun-fei Zheng, Xue-qiong Zhu, Jia-na Mao, Bozhong Xu: “The effect of loop electrosurgical excision on pregnancy during and mode of delivery”. J. Pract. Obstet. Gynecol., 2008, 24, 109.

[8] Nφhr B., Tabor A., Frederiksen K., Kjaer S.K.: “Loop electrosurgical excision of the cervix and the subsequent risk of preterm delivery”. Acta Obstet. Gynecol. Scand., 2007, 86, 596.

[9] Samson S.L., Bentley J.R., Fahey T.J., Mckay D.J., Gill G.H.: “The effect of loop electrosurgical excisional procedure on future pregnancy outcome”. Obstet. Gynecol., 2005, 105, 325.

[10] Jakobsson M., Gissler M., Paavonen J., Tapper A.M.: “Loop electrosurgical excision procedure and the risk for preterm birth”. Obstet. Gynecol., 2009, 114, 504.

[11] Crane J.M.: “Pregnancy outcome after loop electro surgical excision procedure: a systematic review”. Obstet. Gynecol., 2003, 102, 1058.

[12] Houlard S., Perrotin F., Fourquet F., Marret H., Lansac J., Body G.: “Risk factors for cervical stenosis after laser cone biopsy”. Eur. J. Obstet. Gynecol. Reprod. Biol., 2002, 104, 144.

[13] Sadler L., Saftlas A., Wang W., Exeter M., Whittaker J., McCowan L.: “Treatment for cervical intraepithelial neoplasia and risk of preterm delivery”. JAMA, 2004, 291, 2100.

[14] Mathevet P., Chemali E., Roy M., Dargent D.: “Long-term outcome of a randomized study comparing three techniques of conization: cold knife, laser, and LEEP”. Eur. J. Obstet. Gynecol. Reprod. Biol., 2003, 106, 214.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time