宫颈锥切术对妊娠的影响

随着宫颈疾病三阶梯诊断流程的开展,越来越多的宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和早期宫颈癌患者被筛查出来.宫颈锥切术作为一种诊断和治疗方法,因可以保留患者的生育功能而被广泛用于临床,同时新辅助化疗技术的应用扩大了该术式的适用人群,但宫颈锥切术对妊娠的相关影响一直存在争议.宫颈锥切术可能会引起宫颈狭窄、宫颈形态改变、感染等并发症,但对生育能力和分娩方式无明显影响.流产、早产、胎膜早破、低出生体质量儿等妊娠不良结局主要与锥切的术式、高度及体积、至妊娠的间隔时间有关,目前对锥切后是否行预防性宫颈环扎应持谨慎态度.

Effects of cervical conization on pregnancy outcomes

With the method of three-step procedure of diagnosis of cervical disease spreading, more and more cervical intraepithelial neoplasia and early cervical carcinoma was screened.As a diagnosis-treatment method, cervical conizationis widely used in clinical practice because of retaining the fertility function of the patient.Meanwhile the application of neoadjuvant chemotherapy has expanded the applicable population.However,the effect of cervical conization on pregnancy has been controversial.Cervical conization may cause complications such as cervical stenosis,cervical morphology and infection,but it has no significant effect on fertility and mode of delivery.Abortion,preterm birth,premature rupture of membranes,and low birth weight infants are mainly related to the operation,height and volume of coning and the interval between pregnancy.It is prudent for the prevention of cervical cerclage after cervical conization.