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Pregnancy outcome after cervical conization: risk factors for preterm delivery and the efficacy of prophylactic cerclage.

Authors
 Ka Hyun Nam  ;  Ja Young Kwon  ;  Young-Han Kim  ;  Yong-Won Park 
Citation
 JOURNAL OF GYNECOLOGIC ONCOLOGY, Vol.21(4) : 225-229, 2010 
Journal Title
 JOURNAL OF GYNECOLOGIC ONCOLOGY 
ISSN
 2005-0380 
Issue Date
2010
Keywords
Cervical cerclage ; Conization ; Preterm birth
Abstract
OBJECTIVE: This study examined the risk factors for preterm birth and the efficacy of prophylactic cerclage in patients who had undergone cervical conization due to cervical intraepithelial neoplasia before pregnancy. METHODS: We reviewed the medical records of all patients who gave live singleton births between May 1996 and April 2009, after having cervical conization. Delivery before 37 gestational weeks was considered as preterm birth. The pregnancy outcomes were analyzed with independent sample t-test, chi-square test, and multiple logistic regression using the SPSS ver. 12.0. RESULTS: Sixty five cases were found. The mean gestational age at delivery was 37 weeks (SD, 3.5). Eighteen patients (27.7%) had preterm delivery. The type of conization, the volume of the specimen, and second trimester cervical length were related to preterm birth (p≤0.001, p=0.019, p≤0.001, respectively). In multivariate analysis, only mid-trimester cervical length was statistically significant for preterm birth (p=0.012; odds ratio, 0.194; confidence interval, 0.055 to 0.693). Six out of 65 patients had undergone prophylactic cerclage, and three (50%) of them had preterm births, while 15 (25%) patients without cerclage had preterm births. CONCLUSION: The type of conization, the volume of specimen, and second trimester cervical length may be the risk factors for preterm birth in patients who have a prior history of cervical conization. Prophylactic cerclage may not be helpful in preventing preterm birth, therefore more careful consideration should be paid in deciding cerclage after conization during prenatal counseling
Files in This Item:
T201005563.pdf Download
DOI
10.3802/jgo.2010.21.4.225
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ja Young(권자영) ORCID logo https://orcid.org/0000-0003-3009-6325
Kim, Young Han(김영한) ORCID logo https://orcid.org/0000-0003-0645-6028
Nam, Ka Hyun(남가현)
Park, Yong Won(박용원)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103128
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