妊娠合并宫颈上皮内瘤变对围产结局的影响

目的探讨妊娠合并宫颈上皮内瘤变（cervical intraepitherlia neoplasia,CIN）对围产结局的影响。方法采用回顾性研究2007年8月至2010年2月北京妇产医院阴道镜活检病理诊断为正常宫颈及CIN妊娠妇女共108例,分析妊娠合并CIN妇女对围产结局的影响。结果①妊娠合并CIN妇女随CIN级别的升高,其剖宫产率、HR-HPV感染率显著升高,分娩孕周明显提前;②妊娠合并CIN妇女羊水过少及早产儿的发生率显著高于正常宫颈组;③妊娠合并CIN1妇女HR-HPV感染组羊水过少的发生率高于非感染组;分娩方式的选择不影响相关妊娠合并CIN患者围产期并发症的发生。结论妊娠合并CIN妇女孕期应当严密监测羊水过少的情况,尤其是HR-HPV感染患者;排除其他产科手术指征后均可首选阴道分娩。

Effect of cervical intraepithelial neoplasia on perinatal outcome in pregnancy women

Objective To investigate the effect of cervical intraepithelial neoplasia (CIN) on perinatal outcomes.Methods Date of 108 pregnant women with CIN diagnosed by colposcope biopsy at Beijing Obstetrics and Gynecology Hospital from August 2007 to February 2010 were studied retrospectively.The effect of CIN on perinatal outcome was analyzed.Results ① The cesarean section (CS) rate and HR-HPV infection rate in CIN group was obviously higher than that of normal cervical group(control group),and the gestational weeks on term was shorter in CIN group.② Perinatal outcome:the incidence of premature infants (P=0.007)and oligohydramnios(P=0.020) in CIN group was higher compare to the control group.③ The occurrence of oligohydramnios in the HR-HPV infection group was higher than that in non-infection group. The delivery mode of pregnancy women with CIN had no correlation with perinatal complications.Conclusions Pregnanct women with CIN should be closely monitored the occurrence of oligohydramnios, especially those with HR-HPV infection.Excluding other obstetric operation indications, vaginal delivery should be chosen firstly.