Relationship between cervical excisional treatment for cervical intraepithelial neoplasia and obstetrical outcome
| Autor: | Annalisa Scopelliti, Andrea Giannini, Giorgia Perniola, Ludovico Muzii, Valentina Tibaldi, Violante Di Donato, Marco Monti, Vanessa Colagiovanni, Innocenza Palaia, Debora D'Aniello, Giusi Santangelo, Antonella Giancotti, Pierluigi Benedetti Panici |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Birth weight MEDLINE Conization Uterine Cervical Neoplasms cervical intraepithelial neoplasia Cervical intraepithelial neoplasia Pregnancy medicine Humans Prospective Studies Prospective cohort study Retrospective Studies papillomaviridae Obstetrics business.industry Infant Newborn Obstetrics and Gynecology medicine.disease Cervical conization Uterine Cervical Dysplasia Relative risk pregnancy Female business Evidence synthesis |
| Zdroj: | Minerva obstetrics and gynecology. 73(2) |
| ISSN: | 2724-6450 |
| Popis: | Introduction The aim of our systematic review was the assessment of effects of excisional treatments for the management of cervical intraepithelial neoplasia (CIN) on preterm delivery (PD), lower birth weight (LBW), preterm premature rupture of membrane (PPROM) and obstetrical outcomes. Evidence acquisition A structured search was carried out in PubMed-Medline, Embase, and Cochrane Controlled Trials Register databases through November 30, 2019. The search included a combination of the following terms: "loop electrosurgical excision procedure (LEEP)," "large loop excision of transformation zone (LLETZ)," "cold-knife conization (CKC)," "laser cervical conization (CLC)," "preterm delivery" and "neonatal outcome." Evidence synthesis Thirty-two of 561 publications considered were included: 28 retrospective series, 2 prospective studies and 2 multicenter trials. Globally in several studies there was a significant increase in PD, measured by the relative risk, in the women underwent a surgical procedure for the CIN. In their majority, the studies were retrospective and therefore a high risk of bias. Conclusions This systematic review shows that the surgical treatment of the CIN was associated with an increased risk of PD, LBW and pPROM before 37 pregnancy weeks compared to untreated women, especially in a CKC and LLETZ procedure. Moreover, the increase of the of PD was associated with cone size, cervical length, repeated treatment and a short conization-to-pregnancy interval. |
| Databáze: | OpenAIRE |
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