• Obstetrics and gynecology · Oct 2009

    Pregnancy outcome after treatment for cervical intraepithelial neoplasia.

    • Smruta Shanbhag, Heather Clark, Venkat Timmaraju, Siladitya Bhattacharya, and Margaret Cruickshank.
    • University Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Foresterhill, Aberdeen, United Kingdom. s.shanbhag@nhs.net
    • Obstet Gynecol. 2009 Oct 1;114(4):727-35.

    ObjectiveTo estimate the rate of spontaneous preterm delivery and preterm premature rupture of membranes (PROM) in women with cervical intraepithelial neoplasia (CIN) 3.MethodsThis retrospective cohort analysis was performed on routinely collected Scottish national data. The exposed cohort comprised all women with CIN3; the unexposed cohort were women with no record of CIN. Further comparisons were made within the exposed cohort based on the type of treatment they had for CIN3. The primary outcomes were spontaneous preterm delivery and preterm PROM in their first pregnancies.ResultsWomen with CIN3 were significantly more likely to have spontaneous preterm deliveries (11% compared with 6%, odds ratio [OR] 1.52, 95% confidence interval [CI] 1.29-1.80, P<.001) and preterm PROM (8% compared with 6%, OR 1.27, 95% CI 1.09-1.48, P=.001) as compared with the unexposed population. These differences were not seen between the different treatment groups within the exposed cohort.ConclusionWomen with CIN3 have higher rates of spontaneous preterm delivery and preterm PROM than do those in the general population. Loop electrosurgical excision procedure did not alter these pregnancy complication rates. Women should be counseled adequately before treatment but should be reassured regarding the treatment of CIN on the risk of preterm delivery.Level Of EvidenceII.

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