Effects of loop electrosurgical excision procedure or cold knife conization on pregnancy outcomes
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
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.
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.
 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.
 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.
 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.
 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.
 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.
 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.
 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.
 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.
 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.
 Jakobsson M., Gissler M., Paavonen J., Tapper A.M.: “Loop electrosurgical excision procedure and the risk for preterm birth”. Obstet. Gynecol., 2009, 114, 504.
 Crane J.M.: “Pregnancy outcome after loop electro surgical excision procedure: a systematic review”. Obstet. Gynecol., 2003, 102, 1058.
 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.
 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.
 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.
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