高频电波刀宫颈锥切术患者的妊娠结局

目的 评价高频电刀宫颈锥切术(LEEP)对患者日后妊娠的影响.方法 选择2005年1月至2007年1月因宫颈上皮内瘤变在武汉大学人民医院行LEEP并于术后妊娠的85例患者作为研究对象(锥切组).同时随机选取同期在门诊产前检查与之年龄、健康状况、产期相匹配的109例无宫颈疾病治疗史孕妇作为对照组,比较2组的妊娠结局.结果 锥切组早产率与对照组相比相对较高(分别为9.88%、3.70%),但差异无统计学意义(χ2=2.97,P>0.05).2组低出生体重儿、胎膜早破和剖宫产率差异无统计学意义.进一步分析发现,早产的发生主要与锥切术后至妊娠的间隔时间有关,间隔时间<6个月,发生早产的概率更大.结论 LEEP不增加早产、低体重儿、胎膜早破和剖宫产率的风险.LEEP宫颈锥切术是保留患者生育功能的良好选择,但计划妊娠最好在术后6个月以上.

LEEP conization on future obstetrics outcome

Objective To evaluate the implication of LEEP cervical conization on the outcome of subse-quent pregnancy. Methods The study group comprised 85 women who had a LEEP in Renmin Hoapital of Wuhan University during Jan. 2005 and Jan. 2007 ,and then had a subaequent pregnancy. 109 control women were extracted from outpatient clinic who received antenatal care in the same period with no history of cervical surgery, matching by age, health condition and perinatal stage. The pregnancy outcome of two groups were analyzed. Results Women who had a LEEP were more likely to give preterm delivery than controla (9.88% va 3.70%). But there waa no differ-ence in preterm delivery(χ2=2.97, P>0.05). So were low birth weight infants, preterm premature rupture of mem-branes (pPROM) or cesarean section. On a further study, we found that the time interval between cervical conization and subsequent pregnancy was associated with risk of preterm birth. The shorter time interval, especially shorter than 6 months,the higher risk of preterm birth. Conclusions LEEP cervical conization is not associated with an in-creased risk of preterm delivery, low birth weight infants, pPROM or cesarean section. LEEP conization is a more sol-id choice for women who want to preserve reproductive function. But it would be better for them to have pregnancy plan six months later.