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Eur J Obstet Gynecol Reprod Biol. 2012 May;162(1):16-20. doi: 10.1016/j.ejogrb.2012.01.019. Epub 2012 Feb 27.

Obstetric and neonatal outcome after surgical treatment of cervical dysplasia.

Author information

1
Department of Obstetrics and Gynecology, ULB Erasme Hospital, 808 Route de Lennik, 1070 Brussels, Belgium.

Abstract

OBJECTIVES:

Conization is the gold standard today for the management of severe cervical dysplasia. However, with the increasing delay until first pregnancy, obstetric follow-up of patients with a history of conization is a growing concern.

STUDY DESIGN:

Retrospective case-control study using data from the electronic database of a university hospital. We compared the obstetric and neonatal outcome of 106 pregnancies delivered after conization with the outcome of 212 pregnancies of patients with no history of conization.

RESULTS:

A significant reduction in the mean gestational age at delivery (38.23 ± 2.51 weeks vs. 39.15 ± 1.56 weeks) was observed, together with a higher rate of premature rupture of the membrane (9.4% vs. 1.9%), premature onset of labor (9.4% vs. 2.4%), premature delivery (17% vs. 3.8%) and neonatal hospitalization (17.9% vs. 6.6%) in the group of patients with history of conization. Children born to women who had surgery had a significantly lower birth weight (3146.9 ± 611 g vs. 3347.3 ± 502 g) and size (49.1 ± 2.6 cm vs. 50.0 cm ± 2.2 cm) than those of the control group. Furthermore, these children were more frequently admitted in the neonatal intensive care unit (22.6% vs. 10.4%, p=0.004).

CONCLUSIONS:

Conization is an important risk factor for premature birth and women with a history of conization require cautious obstetric management during pregnancy. Anti-HPV vaccination and proactive surveillance of low-grade or moderate dysplasia, instead of immediate surgery, should be encouraged in young patients.

PMID:
22377225
DOI:
10.1016/j.ejogrb.2012.01.019
[Indexed for MEDLINE]

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