Effect Of Cervical Cold Knife Conization And Leep Surgery On Pregnancy Outcome And Cervical Incompetence

Objective:To discuss the effect of cervical cold knife conizasion and Leep surgery on pregnancy outcome and cervical incompetence,and to provide reference for improving the outcome of pregnancy after conization of cervix.Methods:ceive the parallel of surgical treatment of cervical intraepithelial neoplasia(CIN I-III)in patients from the hospital of Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University and Yinzhou People’s Hospital in 2010.1 to 2014.12.99 cases selected as the study object,which were prepared for pregnancy,less than or equal to 40 years old,successful pregnancy and delivery,and according to the different ways of operation will average into two groups,a group for group CKC,another group for group Leep.CKC group has 19 cases of patients,a group of cervical cold knife conization cutting therapy.Group Leep take LEEP treatment.Group Leep has 80cases.Compared two kinds of operation patients with pregnancy outcome and cervical incompetence.In this research,the main indexes were included as followed:age,height,weight,cuting type,cutting frequency,range and depth of conization,preoperative and postoperative pathology,previous pregnancy history,the mode of pregnancy,the outcome of pregnancy,cervical incompetence and so on.Results:1.99cases including 27 natural birth(27.3%),72 caesarean section(72.7%);38 adverse pregnancy outcomes patients(38.38%),14preterm delivery(14.4%),12 premature rupture of membranes(12.2%),12 low birth weight infants(12.12%).2.Cervical conization had no significant effect to the way of delivery(natural birth or caesarean section)(P>0.05),but there was a significant difference between the two groups in the incidence of cervical incompetence and the pregnancy outcome such as preterm delivery,premature rupture of membrane,low birth weight infants(P<0.05).3.There were 75 cases of patients with conization organization cone height<2.5cm,5 preterm delivery,4 premature rupture of membranes,5 low birth weight infants,4 second trimester abortion,20 natural birth,55 Caesarean section,3 cervical incompetence.24 cases of patients with conization organization cone height>2.5cm,9 preterm delivery,8 premature rupture of membranes,7 low birth weight infants,10 second trimester abortion,7 natural birth,17caesarean section,8cervical incompetence.Cervical conization had significant effect to the pregnancy outcome such as preterm delivery,premature rupture of membrane,low birth weight infants and second trimester abortion.Conization organization cone height>2.5cm increased cervical incompetence rate than conization organization cone height<2.5cm group.4.The time from postoperation to pregnancy range 4-39months,with the average time was 13.6months.<12months group 34 cased,including 12 preterm delivery,10premature rupture of membranes,9 low birth weight infants,>12months group 65 cased,including 2 preterm delivery,2 premature rupture of membranes,3 low birth weight infants,The time from postoperation to pregnancy influences preterm delivery,premature rupture of membranes and low birth weight infants.(P<0.05).5.The type of cervical intraepithelial neoplasias had a significant difference in preterm delivery,premature rupture of membrane,low birth weight infants,second trimester abortion and cervical incompetence(P<0.05).The incidence of adverse pregnancy outcomes in patients with CINIII was significantly higher than that in patients with CINI and CINⅡ(P<0.05).Conclusion:1.The cervical cold knife cone cutting operation and loop electrosurgical excision has some effect on patients with pregnancy outcome in some certain.There were significant differences in adverse pregnancy outcomes in different ways;The cervical cold knife cone cutting operation will increase significantly increased cervical incompetence in patients with cervical intraepithelial neoplasia(CIN).2 The time from postoperation to pregnancy,influences pregnancy outcome.Preterm delivery,premature rupture of membranes and low birth weight infants will be increased when the postoperative recovery time was shorter.3.Cervical conization had no significant effect to cervical incompetence,but was correlation with the surgical methods and the range of conization.To hold the indication strictly,reducing the depth of conization will reduce the cervical incompetence rate.4.The rate of caesarean section of the patienter after conization of cervix was correlation with cesarean section indication.Cervical conization was not increased with caesarean section.5.The type of cervical intraepithelial neoplasias associated with adverse pregnancy outcomes.High grade cervical intraepithelial neoplasia increases the incidence of adverse pregnancy outcomes.