The Effect Of Cold Knife Conization On Fertility And Pregnancy Outcome Of Patients With CINⅢ

Objective:To study the effect of cervical cold knife conization therapy on fertility and pregnancy outcome of patients with CIN III.Methods:This research is a retrospective cohort study.We have selected more than 3000 patients with CIN III,Who have already completed the cervical cold knife conization operation.from the Department of Gynecologic Oncology at the Cancer Hospital of Xiangya Medical College of Central South University from January 2005 to December 2015.The patient was informed by the case,and the patients aged between 25 and 35 were screened for telephone follow-up.The patients were informed by the cases and these who aged 25 to 35 years old were screened for telephone follow-up.180 patients aged 25 to 35 years old were selected as the experimental group after the exclusion of basic infertility,long-term contraception,childless demand,smoking,excessive sexual intercourse,sexual partners,mental illness and major diseases.similarly,The women aged from 25 to 35 years old in Gynecology Outpatient Clinic of hunanprovince tumor hospital were screened for telephone follow-up.We selected 200 healthy women with fertility requirements and no history of CIN and cervical surgery,as control group.without doubt,other interference factors were ruled out.The correlation between the data of the follow-up visit(Including pregnancy,premature birth,abortion,premature rupture of membranes,cervical cerclage,perinatal death,ectopic pregnancy,cesarean section and vaginal delivery cervical laceration,assisted reproduction,spuc and low birth weight during pregnancy of the patients)and cold knife conization was analyzed.A summary analysis was conducted and SPSS22.0 was used for statistical analysis.The data was statistically analyzed by using chi-square test,Fisher exact test and Logistic regression analysis,and P<0.05 was considered statistically significant.Results:Cold-knife conization has no significant effect on fertility,premature birth,miscarriage,assisted reproduction and perinatal fetal death(P>0.05).And have certain effects on Premature rupture of membranes(P =0.009,RR =2.526,95% CI: 1.263-5.049),insufficiency of cervical function(P=0.002,RR=6.968,95% CI:1.584-30.654),ectopic pregnancy(P<0.01,RR=8.346,95% CI:1.038-67.105),cesarean section(P<0.01,RR=1.655,95%CI:1.285-2.131,cervical vaginal delivery(P=0.043),gestationalhospitalization(P<0.01,RR = 2.102,95% CI: 1.275-3.465),low birth weight infants.(P = 0.034,RR = 2.800,95% CI: 1.105-7.094).Conclusion:1.Cold knife conization has no significant effect on fertility.2.Cold knife conization has no significant effect premature birth,miscarriage,perinatal fetal death,and assisted reproduction.3.Cold knife conization increases the occurrence of premature rupture of membranes,insufficiency of cervical function,ectopic pregnancy,cesarean section,cervical laceration in vaginal delivery,hospitalization during pregnancy,and low birth weight.Specifically,the premature rupture of fetal membrane and the increase of pregnancy rate were mainly occurred in less than 28 weeks.The increase of cesarean section rate was mainly due to social factors.