高度鳞状上皮内瘤变锥切术后的妊娠结局

Pregnancy outcome of patients with high-grade squamous intraepithelial lesion after conization

目的探讨宫颈锥切术对高度鳞状上皮内瘤变(HSIL)患者妊娠结局的影响。方法收集湖北省妇幼保健院2003年12月~2017年12月因HSIL入院行宫颈锥切术,且术后初次妊娠并成功分娩者114例,其中行高频电波环切术(LEEP)者74例,冷刀宫颈锥切术(CKC)者40例。比较两组锥切术后妊娠结局、分娩方式,观察手术至妊娠时间对妊娠结局的影响。结果两组产妇在妊娠周数、早产率、胎膜早破率、低出生体重儿率、新生儿平均体重、剖宫产率及剖宫产指征分布的差异无统计学意义(P>0.05)。114例分娩患者中,剖宫产率为70.2%。手术至妊娠时间对妊娠结局无明显影响(P>0.05)。结论不同宫颈锥切手术方式以及手术至妊娠时间对术后妊娠结局无明显影响,锥切术后患者有选择剖宫产的倾向。

Objective To discuss the effect of cervical conization on pregnancy outcome of patients with high-grade squamous intraepithelial lesion(HSIL).Methods One hundred and fourteen patients with HSIL treated by cervical conization in Hubei Meternal and Child Health Hospital were included from December 2003 to December 2017,and all the patients were primigravid and successful delivery.Among them,74 cases received high frequency wave loop resection(LEEP)and 40 cases received cold knife conization(CKC).The pregnancy outcome,delivery mode were compared between the two groups,and the effect of the interval time from pregnancy to operation on pregnancy outcome was observed.Results There were no significant differences in gestational weeks,preterm birth rate,premature rupture of membranes rate,low birth weight infants rate,average neonatal weight,cesarean section rate,and distribution of cesarean section indications between the two groups(P>0.05).Among 114 delivery cases,the cesarean section rate was 70.2%.The interval time from pregnancy to operation had no significant effect on pregnancy outcome(P>0.05).Conclusion Different cervical conization methods and the interval time from conization to pregnancy had no significant effect on the postoperative pregnancy outcome,but these women have tendency to choose cesarean section after conization.