| Objective:The purpose of this study is to investigate the fertility of the young women treated by loop electrosurgical excisional procedure (LEEP).Methods:We collected 103 women under 35 years old who were treated by LEEP in the Department of Obstetrics and Gynaecology of Guangdong General Hospital between 2000 and 2007 and attending to generate. The 106 women of control group were randomly collected from outpatients without cervical treatment who came for physical examination or came to check body for pregnancy. Women who had medical illnesses, surgical diseases or other gynecological diseases were excluded. We gathered the data of pregnancy rate, way to conceive, obstetric outcomes, delivery pattern and neonate of these women, built a data base with Epidata 3.1 and analyzed the data with SPSS 13.0 (t test for measurement data,χ2 test for count data). P<0.05 was considered statistically significant.Results:1. Influence of LEEP on fertilization:We lost 3 patients in the case group (one withdrew from the follow-up, one was diagnosed sterility and one prepared to gestate for 6 months).102 women of the case group gestated naturally within 2 years, one by IVF-ET. In the control group, there were 103 gestated naturally, one IUI and one sterility. Comparison of pregnancy rate and pregnancy pattern between the two groups proved to be with no significance (P> 0.05).2. Influence of excision depth and width on fertilization:We delivered the cases into three groups by depth (10-15mm,16-20mm, and 21-25mm) and two groups by width (15-20mm, 21-40mm). In the group with excision depth of 16-20mm and width of 21-40mm, there was one gestated by IVF-ET, one was diagnosed sterility. The others gestated naturally. Comparison of pregnancy rate and pregnancy pattern among groups approved to be with no significance (P>0.05).3. Influence of LEEP on obstetric outcomes:Among the 103 cases, there was one gravida with the gestation of 28weeks who was excluded from this analyze. In the rest 102 women, there was one abortion, two premature birth, two premature rupture of membrane, and 99 term birth. Among the 104 controls, there was one 8-week-gestation who was excluded. In the rest 103 women, there was one abortion, two premature birth, six premature rupture of membrane, and 101 term birth. There were no small for gestational age infants in both groups. The difference of the rate of abortion, premature birth, premature rupture of membrane and gestation week when birth between the two groups was not significant (p>0.05). Birth weight of the cases was significantly bigger than the controls (p<0.05).4. Influence of excision depth and width on f obstetric outcomes:We delivered the cases into three groups by depth (10-15mm,16-20mm, and 21-25mm) and two groups by width (15-20mm,21-40mm). The difference of the rate of abortion, premature birth, premature rupture of membrane and gestation week when birth among groups was not significant (p> 0.05).5. Influence of pregnancy intervals after LEEP on pregnancy outcomes:In the 102 women who gestated after LEEP,27 got pregnant 12months after conization (one premature rupture of membrane,9 abdominal delivery),43 got pregnant 13-24 months after conization (one premature rupture of membrane,14 abdominal delivery),32 of the 102 women gestated more than 25months after conization (one abortion, two premature birth,14 abdominal delivery). The analyze shows that pregnancy intervals after LEEP will nct lead to different rate of abortion, premature birth, premature rupture of membrane and abdominal delivery (p>0.05).6. Influence of LEEP on delivery pattern:One hundred and one women of the case group delivered with the gestational of more than 28 weeks.64 of them labored naturally,38 of them labored abdominally, and one of them had a forceps delivery. There is no significance at the frequency distribution of delivery pattern in the cases and controls. To investigate the reason for abdominal delivery in both groups, senile pregnancy (12 in the cases,1 in the controls) is the main cause, and the difference between is statistically significant (p<0.05).7. Age of the puerpera in the cases and controls:Of the 101 delivered women in case group, thirty-eight aged 20-30, forty-one aged 30-35, twenty aged not less than 35 years old. The average delivery age was 31.4±3.2(S±D). Of the 103 delivered women in control group, ninety-five aged 20-30, six aged 30-35, two aged not less than 35. The average delivery age was 26.5±3.3(S±D). Delivery age of both group is different significantly (p<0.001).Conclusions:1. LEEP conization doesn't affect the rate of pregnancy and way to conceive significantly.2. LEEP conization doesn't affect the obstetric outcome and delivery pattern significantly.3. Adverse outcome such as abortion, premature birth, premature rupture of membrane and small for gestational age infants don't increased significantly provided the excision depth less than 25mm, and the excision width less than 40mm.4. LEEP may increase the number of advanced age parturient woman.5. The rate of abortion, premature birth, premature rupture of membrane and small for gestational age infants don't increased significantly in the women who pregnant within 12 months after LEEP compared with the ones who pregnant more than 12 months after the surgery. |
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