OBSTETRIC OUTCOMES AFTER CERVICAL CONIZATION: A SINGLE-CENTER DESCRIPTIVE REVIEW

Cervical conization, or large loop excision of the transformation zone (LLETZ) is the most effective method to treatHigh-Grade Intraepithelial Lesion (HSIL). Some studies have shown a relation between preterm birth and history of cervical conization1,2, but no clear association has been proven3,4.

The aim of this study is to understand the impact of cervical conization on obstetric outcomes.

Methods

Retrospective observational study including women who got pregnant after being submited to a LLETZ, in Hospital São Francisco de Xavier, Lisbon, from January 2006 to December 2022.

Results

During this 16-year period 919 LLETZ were made. 118 patients got pregnant after conization, 18 had more than one pregnancy. Regarding these patients, mean age at the moment LLETZ was preformed was 30,5 (19-47) years, and mean age at the time of conception was 33,4 (22-48) years. The mean interval conization to birth was 35 months ± 24,8 SD.

In a total of 138 pregnancies, 93 gave birth to a live newborn and 32 pregnancies loss were registered: 28 in the first trimester, 2 in the second trimester and 2 ectopic pregnancies, and 7 voluntary abortions were performed.

Mean gestacional week at term delivery was 38,9 (37-41) weeks, with a cesarean rate of 23,3% (n=20/86). Fetal weight 3054,7± 570 g, and the rate of low-birth-weight infants was 8,1% (n= 7/86). There are four ongoing pregnancies, without registered incidents until this moment.

The rate of preterm birth (PTB) was 9,7% (n=9), with a mean gestacional age of 33,4 (24-36) weeks, and mean fetal weight of 2069,3 g. These preterm deliveries include two placenta previa, a gemelar gestacion with a vaginal delivery at 36 weeks, and a iatrogenic PTB at 24 weeks justified with maternal pathology (severe respiratory infection). Occurrence of premature rupture of membranes was 2,15% (n=2). Time between LLETZ and birth was 31 months ± 26,9 SD.

Conclusions

In this study, the cervical conization does not seem to increase the risk of PTB of women who do not have other PTB risk factors, and delaying pregnancy after LLETZ did not reduce the incidence of PTB.

We have no conflicts of interest to disclose.