Obstetric and neonatal outcome after surgical treatment of cervical dysplasia

Eur J Obstet Gynecol Reprod Biol. 2012 May;162(1):16-20. doi: 10.1016/j.ejogrb.2012.01.019. Epub 2012 Feb 27.

Abstract

Objectives: Conization is the gold standard today for the management of severe cervical dysplasia. However, with the increasing delay until first pregnancy, obstetric follow-up of patients with a history of conization is a growing concern.

Study design: Retrospective case-control study using data from the electronic database of a university hospital. We compared the obstetric and neonatal outcome of 106 pregnancies delivered after conization with the outcome of 212 pregnancies of patients with no history of conization.

Results: A significant reduction in the mean gestational age at delivery (38.23 ± 2.51 weeks vs. 39.15 ± 1.56 weeks) was observed, together with a higher rate of premature rupture of the membrane (9.4% vs. 1.9%), premature onset of labor (9.4% vs. 2.4%), premature delivery (17% vs. 3.8%) and neonatal hospitalization (17.9% vs. 6.6%) in the group of patients with history of conization. Children born to women who had surgery had a significantly lower birth weight (3146.9 ± 611 g vs. 3347.3 ± 502 g) and size (49.1 ± 2.6 cm vs. 50.0 cm ± 2.2 cm) than those of the control group. Furthermore, these children were more frequently admitted in the neonatal intensive care unit (22.6% vs. 10.4%, p=0.004).

Conclusions: Conization is an important risk factor for premature birth and women with a history of conization require cautious obstetric management during pregnancy. Anti-HPV vaccination and proactive surveillance of low-grade or moderate dysplasia, instead of immediate surgery, should be encouraged in young patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight
  • Case-Control Studies
  • Conization / adverse effects*
  • Databases, Factual
  • Female
  • Fetal Membranes, Premature Rupture / etiology*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Premature Birth / etiology*
  • Retrospective Studies
  • Risk Factors
  • Uterine Cervical Dysplasia / surgery*