The Clinical Study Of The Subsequent Fertility And Pregnancy Outcome After Cervical Conization For Intraepithelial Neoplasia

Objective To evaluate the impact of the cervical conization for intraepithelial neoplasia including carcinoma in situ on the outcome of subsequent fertility and pregnancy.Methods A retrospective study was performed of patients who underwent conization from 2001 to 2006 in the Second Xiang Ya Hospital of central south university for intraepithelial neoplasia and carcinoma in situ.The patients below 40 years old who were not primary or secondary infertility, who had not given a birth, who had given a birth but still had requirements of pregnancy, were followed up.25 cases who desired to conceive and didn't have contraception more than two year were retrospectively analyzed on fertility , pregnancy outcome, pregnancy- conization interval, the manner of termination of pregnancy.Results 1. Fertility :20 patients with a total of 21 pregnancies among 25 patients, pregnancy rate of 80% (20/25), compared with the pregnancy rate of normal crowd, difference was not statistically significant (P>0.05) .2. Pregnancy outcome: Of the 21 pregnancies , one case of missed abortion, one case of second trimester labor induction, 19 cases of alive childbirth (one case had a missed abortion before), among the 19 cases, two cases of premature delivery, one's gestational week was 34 weeks , one of 36⁺³ weeks ,premature delivery rate was 11% (2/19) ,compared with the premature delivery rate of normal crowd, difference was not statistically significant (P>0.05) ; one case of premature rupture of membranes in 34 gestational week,the rate of premature rupture of membranes was 5.3% (1/19) , compared with the rate of premature rupture of normal crowd, difference was not statistically significant (P > 0.05) ; one case of postterm delivery ,sixteen cases of term delivery ;19 babies in all,the minimum birth weight was2600g,the maximum birth weight was 4200g,mean birth weight was 3374±438g, no occurrence of low birth weight infant and infant death in all cases.3. Pregnancy- conization interval:the minimum pregnancy-Conization interval was 4 months, the maximum was 48 months, pregnancy- conization interval of the two premature delivery cases were 12 months and16 months separately, no premature delivery was found among the cases whose pregnancy- conization interval were within 6 months. pregnancy-conization interval had no significant association with premature delivery.4. The manner of termination of pregnancy :four cases of term vaginal delivery, parturition labor were normal ,no dystocia; fifteen cases of cesarean section,among the fifteen cases,seven cases cesarean section for obstetric reason,eight cases required cesarean section not for obstetric reason ,cesarean rate was 78.9% (15/19), all cases of cesarean were not in labor, did't try to do vaginal delivery,whether cervical dystocia will happen was unknown.Conclusion 1. If severe stenosis didn't occur, there was no impact on fertility after cervical conization ,no evidence of secondary infertility caused by cervical conization was found.2. There was no significant increase in the number of either of premature delivery cases or premature rupture of membranes cases , the number of low birth weight infants and infant death didn't significantly increase.3. Pregnancy- conization interval had no significant association with premature delivery.