Literature Review of Cervical Regeneration after Loop Electrosurgical Excision Procedure, and Study Project (CeVaLEP) Proposal.

Autor: Lūse L; Faculty of Residency, Rīga Stradiņš University, LV-1007 Riga, Latvia., Urtāne AĶ; Department of Public Health and Epidemiology, Rīga Stradiņš University, LV-1007 Riga, Latvia., Lisovaja I; Faculty of Residency, Rīga Stradiņš University, LV-1007 Riga, Latvia., Jermakova I; Gynecology Department, Riga Eastern Clinical University Hospital, LV-1079 Riga, Latvia., Donders GGG; Department OB/Gyn, Antwerp University Hospital, 2650 Edegem, Belgium.; Femicare VZW, Clinical Research for Women, 3300 Tienen, Belgium., Vedmedovska N; Department of Obstetrics and Gynecology, Rīga Stradiņš University, LV-1007 Riga, Latvia.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Apr 08; Vol. 11 (8). Date of Electronic Publication: 2022 Apr 08.
DOI: 10.3390/jcm11082096
Abstrakt: Objective: To compile existing knowledge on the level of cervical regeneration (detected by ultrasound) after loop electrosurgical excision procedure (LEEP) and to suggest research protocol for further studies.
Methods: We conducted a literature search of Medline, Web of Science, Scopus, and Cochrane databases using the keywords "cervix" and "regeneration" without year restrictions. Our eligibility criteria included studies that analysed cervical volume and length regeneration using ultrasound. A literature review was conducted following PRISMA guidelines and registered in PROSPERO (reg. no. CRD42021264062). Information about the studies was extracted from each analysed study on an Excel datasheet and the average regeneration with standard deviation was calculated. All included studies' possible biases were assessed by the National Institutes of Health's (NIH) quality assessment tool.
Results: The literature search identified 802 papers and four trials ( n = 309) that met our criteria. They investigated cervical length and volume regeneration after LEEP using ultrasound, concluding that there is a profound regeneration deficit. Average cervical length regeneration after 6 months was 83.4% (±10.8%) and volume regeneration was 87.4% (±6.1%). All analysed studies had their biases; therefore, based on the conducted studies' protocols, we present a CeVaLEP research protocol to guide high-quality studies.
Conclusion: After LEEP, there is a cervical regeneration deficit. There is a lack of high-quality studies that assess cervical volume regeneration and its relation to obstetrical outcomes. There is a gap in the field and more research is needed to define the prenatal risks related to cervical regeneration.
Databáze: MEDLINE
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