Document Detail


Pregnancy management after cervical surgery.
MedLine Citation:
PMID:  18989126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: An amplified risk of adverse pregnancy outcomes after excisional cervical surgery has been identified. Procedures such as cold-knife conization, laser conization, loop electrosurgical excision procedure, and trachelectomy increase the risk of preterm delivery and preterm premature rupture of membranes. Few studies have evaluated prenatal care considerations after these procedures. This review discusses pregnancy management after cervical surgery. RECENT FINDINGS: Data showing an association between excisional and ablative procedures of the cervix and subsequent preterm delivery or preterm premature rupture of membranes are increasing and include more recent information from larger case series and meta-analyses. The need for appropriate and evidence-based management strategies during subsequent pregnancy has arisen. Screening for genital tract infection, sonographic cervical length surveillance, and progesterone administration for cervical shortening may lead to improved pregnancy outcomes in women at high risk for preterm delivery, including women who have undergone cervical surgery. Modifiable risk factors such as depth of conization and procedure-to-pregnancy time interval should be recognized and clinicians should avoid overtreatment for preinvasive cervical lesions. SUMMARY: A number of procedures performed for a variety of indications can be considered excisional cervical surgery. As a result, no standard recommendations for pregnancy management following cervical surgery exist. Given the increased risk of pregnancy complications, certain screening tests or interventions may be appropriate for these women.
Authors:
Jennifer A Jolley; Deborah A Wing
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in obstetrics & gynecology     Volume:  20     ISSN:  1473-656X     ISO Abbreviation:  Curr. Opin. Obstet. Gynecol.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-07     Completed Date:  2009-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007264     Medline TA:  Curr Opin Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  528-33     Citation Subset:  IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of California at Irvine, Irvine, California 92868, USA. mfm@uci.edu
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MeSH Terms
Descriptor/Qualifier:
Cervical Intraepithelial Neoplasia / surgery*
Female
Fetal Membranes, Premature Rupture / etiology
Humans
Lasers
Obstetric Labor, Premature / etiology
Obstetrics / methods
Pregnancy
Pregnancy Outcome
Premature Birth / etiology
Progesterone / administration & dosage
Risk
Risk Factors
Uterine Cervical Neoplasms / surgery*
Chemical
Reg. No./Substance:
57-83-0/Progesterone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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