Literature DB >> 21278884

The role of prophylactic cerclage in preventing preterm delivery after electrosurgical conization.

Mi-Young Shin1, Eun-Sung Seo, Suk-Joo Choi, Soo-Young Oh, Byoung-Gie Kim, Duk-Soo Bae, Jong-Hwa Kim, Cheong-Rae Roh.   

Abstract

OBJECTIVE: To evaluate pregnancy outcomes after electrosurgical conization.
METHODS: We retrospectively analyzed the outcomes of 56 singleton pregnancies after electrosurgical conization of the uterine cervix. Of the 56 cases, 25 women underwent prophylactic cerclage with McDonald procedure (cerclage group), and 31 were managed expectantly (expectant group). Pregnancy outcomes including rate of preterm delivery were compared, and the effect of potential risk factors such as depth of cone, interval between conization and pregnancy, and cervical length on the risk of preterm delivery was assessed.
RESULTS: The rate of preterm delivery was significantly higher in women with a history of electrosurgical conization than those without (32.1% vs. 15.2%, p<0.001). However, preterm delivery rate was not different between the two groups (expectant group vs. cerclage group; <28 week, 6.5% vs. 8.0%, p=1.000; <34 week, 19.4% vs. 20.0%, p=1.000; <37 week, 29.0% vs. 36.0%, p=0.579). All obstetric and neonatal outcomes were similar in the two groups. Even when we confined the study subjects to 19 women (19/56, 33.9%) with cervical length less than 25 mm, the preterm delivery rate also was not significantly different between the expectant (n=7) and cerclage group (n=12). Finally, the potential risk factors for preterm delivery were not associated with risk of preterm delivery in patients with a history of electrosurgical conization.
CONCLUSION: The rate of preterm delivery was significantly higher in women with a history of electrosurgical conization before pregnancy. However, prophylactic cervical cerclage did not prevent preterm delivery in these patients.

Entities:  

Keywords:  Cervical cerclage; Conization; Preterm birth

Year:  2010        PMID: 21278884      PMCID: PMC3026301          DOI: 10.3802/jgo.2010.21.4.230

Source DB:  PubMed          Journal:  J Gynecol Oncol        ISSN: 2005-0380            Impact factor:   4.401


  23 in total

1.  Prophylactic cerclage in pregnancy. Effect in women with a history of conization.

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Journal:  J Reprod Med       Date:  1997-07       Impact factor: 0.142

2.  The outcome of pregnancy after cone biopsy of the cervix: a case-control study.

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Journal:  Acta Obstet Gynecol Scand       Date:  1979       Impact factor: 3.636

4.  An international classification of retinopathy of prematurity.

Authors: 
Journal:  Pediatrics       Date:  1984-07       Impact factor: 7.124

5.  The outcome of pregnancy and preterm delivery after conization of the cervix.

Authors:  G B Kristensen
Journal:  Arch Gynecol       Date:  1985

6.  Pregnancy following conization of the cervix: complications related to cone size.

Authors:  G Leiman; N A Harrison; A Rubin
Journal:  Am J Obstet Gynecol       Date:  1980-01-01       Impact factor: 8.661

7.  Large loop excision of the transformation zone (LLETZ). A new method of management for women with cervical intraepithelial neoplasia.

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Journal:  Br J Obstet Gynaecol       Date:  1989-09

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Authors:  J Kristensen; J Langhoff-Roos; F B Kristensen
Journal:  Obstet Gynecol       Date:  1993-06       Impact factor: 7.661

9.  The effect of cervical loop electrosurgical excision on subsequent pregnancy outcome: North American experience.

Authors:  A Ferenczy; D Choukroun; T Falcone; E Franco
Journal:  Am J Obstet Gynecol       Date:  1995-04       Impact factor: 8.661

10.  Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging.

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Journal:  Ann Surg       Date:  1978-01       Impact factor: 12.969

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  10 in total

1.  Importance of uterine cervical cerclage to maintain a successful pregnancy for patients who undergo vaginal radical trachelectomy.

Authors:  Miseon Kim; Shin-ichi Ishioka; Toshiaki Endo; Tsuyoshi Baba; Yushi Akashi; Miyuki Morishita; Hidefumi Adachi; Tsuyoshi Saito
Journal:  Int J Clin Oncol       Date:  2013-10-31       Impact factor: 3.402

2.  Prediction and prevention of preterm birth after cervical conization.

Authors:  Seung Mi Lee; Jong Kwan Jun
Journal:  J Gynecol Oncol       Date:  2010-12-31       Impact factor: 4.401

Review 3.  Vaginal progesterone vs. cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix, previous preterm birth, and singleton gestation: a systematic review and indirect comparison metaanalysis.

Authors:  Agustin Conde-Agudelo; Roberto Romero; Kypros Nicolaides; Tinnakorn Chaiworapongsa; John M O'Brien; Elcin Cetingoz; Eduardo da Fonseca; George Creasy; Priya Soma-Pillay; Shalini Fusey; Cetin Cam; Zarko Alfirevic; Sonia S Hassan
Journal:  Am J Obstet Gynecol       Date:  2012-11-15       Impact factor: 8.661

4.  Conservative Treatment of Stage IA1 Adenocarcinoma of the Uterine Cervix during Pregnancy: Case Report and Review of the Literature.

Authors:  Francesco Sopracordevole; Diego Rossi; Jacopo Di Giuseppe; Marta Angelini; Pierino Boschian-Bailo; Monica Buttignol; Andrea Ciavattini
Journal:  Case Rep Obstet Gynecol       Date:  2014-03-16

5.  Post-cerclage ultrasonographic cervical length can predict preterm delivery in elective cervical cerclage patients.

Authors:  Rok Katerina Song; Hyun-Hwa Cha; Mi-Young Shin; Suk-Joo Choi; Soo-Young Oh; Jong-Hwa Kim; Cheong-Rae Roh
Journal:  Obstet Gynecol Sci       Date:  2016-01-15

6.  Preterm Birth Prevention Post-Conization: A Model of Cervical Length Screening with Targeted Cerclage.

Authors:  Lindsay M Kindinger; Maria Kyrgiou; David A MacIntyre; Stefano Cacciatore; Angela Yulia; Joanna Cook; Vasso Terzidou; T G Teoh; Phillip R Bennett
Journal:  PLoS One       Date:  2016-11-03       Impact factor: 3.240

7.  Therapeutic dilemma in patients with short cervices during pregnancy after conization.

Authors:  Shunji Suzuki
Journal:  Int J Womens Health       Date:  2017-02-23

8.  Cerclage is associated with the increased risk of preterm birth in women who had cervical conization.

Authors:  Geum Joon Cho; Yung-Taek Ouh; Log Young Kim; Tae-Seon Lee; Geun U Park; Ki Hoon Ahn; Soon-Cheol Hong; Min-Jeong Oh; Hai-Joong Kim
Journal:  BMC Pregnancy Childbirth       Date:  2018-07-03       Impact factor: 3.007

Review 9.  Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth: systematic review and meta-analysis.

Authors:  Maria Kyrgiou; Antonios Athanasiou; Maria Paraskevaidi; Anita Mitra; Ilkka Kalliala; Pierre Martin-Hirsch; Marc Arbyn; Phillip Bennett; Evangelos Paraskevaidis
Journal:  BMJ       Date:  2016-07-28

10.  Evaluation of cervical length and optimal timing for pregnancy after cervical conization in patients with cervical intraepithelial neoplasia: A retrospective study.

Authors:  Xiao Zhang; Jinfei Tong; Xudong Ma; Hailan Yu; Xiaojing Guan; Jianqiong Li; Jianhua Yang
Journal:  Medicine (Baltimore)       Date:  2020-12-04       Impact factor: 1.817

  10 in total

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