Andrea Ciavattini1, Nicolò Clemente2, Giovanni Delli Carpini2, Chiara Gentili2, Jacopo Di Giuseppe2, Pamela Barbadoro3, Emilia Prospero3, Carlo Antonio Liverani4. 1. Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy. Electronic address: ciavattini.a@libero.it. 2. Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy. 3. Department of Biomedical Science and Public Health, Polytechnic University of Marche, Ancona, Italy. 4. Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Abstract
OBJECTIVE: To evaluate the risk of miscarriage in the subsequent pregnancy after a loop electrosurgical excision procedure (LEEP), also considering time elapsed from LEEP to pregnancy. DESIGN: Multicenter, retrospective cohort study. SETTING: Tertiary care university hospitals. PATIENT(S): Women who had undergone LEEP from January 2000 to December 2011. Women with histologic assessment of low-grade cervical dysplasia, not requiring subsequent surgical treatment, constituted the control group. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The first pregnancy after the procedure was evaluated, and only women with singleton spontaneous pregnancies were considered. Women with time intervals of <12 months and women with intervals of ≥12 months or more from LEEP to pregnancy were then compared, to identify adjusted odds ratios for miscarriage. RESULT(S): In women previously treated with LEEP, a total of 116 cases of miscarriage (18.1%) was reported. The mean time interval from LEEP to pregnancy for women with miscarriage compared with women without miscarriage was significantly shorter (25.1 ± 11.7 months vs. 30.1 ± 13.3 months). A higher rate of miscarriage in women with a LEEP-to-pregnancy interval of <12 months compared with controls emerged (28.2% vs. 13.4%; adjusted odds ratio 2.60, 95% confidence interval 1.57-4.3). No significant difference in the rate of miscarriage in women with a LEEP-to-pregnancy interval of ≥12 months compared with controls emerged. CONCLUSION(S): Women with a time interval from LEEP to pregnancy of <12 months are at increased risk for miscarriage.
OBJECTIVE: To evaluate the risk of miscarriage in the subsequent pregnancy after a loop electrosurgical excision procedure (LEEP), also considering time elapsed from LEEP to pregnancy. DESIGN: Multicenter, retrospective cohort study. SETTING: Tertiary care university hospitals. PATIENT(S): Women who had undergone LEEP from January 2000 to December 2011. Women with histologic assessment of low-grade cervical dysplasia, not requiring subsequent surgical treatment, constituted the control group. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The first pregnancy after the procedure was evaluated, and only women with singleton spontaneous pregnancies were considered. Women with time intervals of <12 months and women with intervals of ≥12 months or more from LEEP to pregnancy were then compared, to identify adjusted odds ratios for miscarriage. RESULT(S): In women previously treated with LEEP, a total of 116 cases of miscarriage (18.1%) was reported. The mean time interval from LEEP to pregnancy for women with miscarriage compared with women without miscarriage was significantly shorter (25.1 ± 11.7 months vs. 30.1 ± 13.3 months). A higher rate of miscarriage in women with a LEEP-to-pregnancy interval of <12 months compared with controls emerged (28.2% vs. 13.4%; adjusted odds ratio 2.60, 95% confidence interval 1.57-4.3). No significant difference in the rate of miscarriage in women with a LEEP-to-pregnancy interval of ≥12 months compared with controls emerged. CONCLUSION(S): Women with a time interval from LEEP to pregnancy of <12 months are at increased risk for miscarriage.
Authors: Andrea Ciavattini; Matteo Serri; Jacopo Di Giuseppe; Carlo Antonio Liverani; Barbara Gardella; Maria Papiccio; Giovanni Delli Carpini; Stefano Morini; Nicolò Clemente; Francesco Sopracordevole Journal: BMJ Open Date: 2019-07-03 Impact factor: 2.692
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