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The role of prophylactic cerclage in preventing preterm delivery after electrosurgical conization.
MedLine Citation:
PMID:  21278884     Owner:  NLM     Status:  PubMed-not-MEDLINE    
OBJECTIVE: To evaluate pregnancy outcomes after electrosurgical conization.
METHODS: We retrospectively analyzed the outcomes of 56 singleton pregnancies after electrosurgical conization of the uterine cervix. Of the 56 cases, 25 women underwent prophylactic cerclage with McDonald procedure (cerclage group), and 31 were managed expectantly (expectant group). Pregnancy outcomes including rate of preterm delivery were compared, and the effect of potential risk factors such as depth of cone, interval between conization and pregnancy, and cervical length on the risk of preterm delivery was assessed.
RESULTS: The rate of preterm delivery was significantly higher in women with a history of electrosurgical conization than those without (32.1% vs. 15.2%, p<0.001). However, preterm delivery rate was not different between the two groups (expectant group vs. cerclage group; <28 week, 6.5% vs. 8.0%, p=1.000; <34 week, 19.4% vs. 20.0%, p=1.000; <37 week, 29.0% vs. 36.0%, p=0.579). All obstetric and neonatal outcomes were similar in the two groups. Even when we confined the study subjects to 19 women (19/56, 33.9%) with cervical length less than 25 mm, the preterm delivery rate also was not significantly different between the expectant (n=7) and cerclage group (n=12). Finally, the potential risk factors for preterm delivery were not associated with risk of preterm delivery in patients with a history of electrosurgical conization.
CONCLUSION: The rate of preterm delivery was significantly higher in women with a history of electrosurgical conization before pregnancy. However, prophylactic cervical cerclage did not prevent preterm delivery in these patients.
Mi-Young Shin; Eun-Sung Seo; Suk-Joo Choi; Soo-Young Oh; Byoung-Gie Kim; Duk-Soo Bae; Jong-Hwa Kim; Cheong-Rae Roh
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Publication Detail:
Type:  Journal Article     Date:  2010-12-31
Journal Detail:
Title:  Journal of gynecologic oncology     Volume:  21     ISSN:  2005-0399     ISO Abbreviation:  J Gynecol Oncol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-01-31     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101483150     Medline TA:  J Gynecol Oncol     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  230-6     Citation Subset:  -    
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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