Korean J Perinatol.  2010 Sep;21(3):273-281.

Pregnancy Outcomes after Conservative Treatment of Cervical Intraepithelial Lesions: Cold Knife Conization and Loop Electrosurgical Procedure

• Kim YY
• Chae YH
• An GH
• Woo JH
• Choi JS
• Kim MH
• Ryu HM
• Choi KH
• Han JY
• Lee SW
• Ahn HK
• Yang JH
• Kim MY

Abstract

OBJECTIVE
In this study, we evaluated whether different methods of conization of the cervix were associated with an increased risk of adverse pregnancy outcomes in subsequent pregnancy.
METHODS
A retrospective case-control study was conducted. The study group included women who had undergone cold knife conization (n=170) or a loop electrosurgical excision procedure (LEEP) (n=86) and then had subsequent singleton pregnancies. The control group (n=497) included women with no history of cervical surgery. The outcomes were spontaneous preterm delivery and various neonatal outcomes such as low birth weight (LBW) and perinatal mortality.
RESULTS
Cold knife conization was associated with a significantly increased risk of preterm delivery less than 34 weeks (relative risk 4.9, 95% confidence interval 1.6-15.1), preterm delivery less than 28 weeks (7.6, 15-39.6), LBW (2.6, 1.2-5.8), and perinatal mortality (11.9, 1.3-107.6). LEEP was not associated with a increased risk of adverse pregnancy outcomes.
CONCLUSION
Cold knife cone biopsy, but not LEEP of the cervix, is associated with an increased risk of preterm delivery less than 34 weeks of gestation and adverse neonatal outcomes. Clinicians counsel women appropriately before conservative treatment of cervical intraepithelial lesions.

Keyword

Premature birth; Cervix; Cold knife conization; LEEP

MeSH Terms

Biopsy
Case-Control Studies
Cervix Uteri
Cold Temperature
Conization
Female
Humans
Infant, Low Birth Weight
Infant, Newborn
Perinatal Mortality
Pregnancy
Pregnancy Outcome
Premature Birth
Retrospective Studies