Comparison Of The Effects Of Cold Knife Conization Versus Electrosurgical Procedure On Pregnancy Outcome A Meta-analysis

Objective Compare the effects of cold knife conization(CKC)and loop electrosurgical excision procedure(LEEP)on pregnancy-related conditions for high-grade cervical intraepithelial lesions in the way of meta-analysis.Methods Develop a search strategy and search the Internet for randomized controlled trials(RCT)published by CNKI,Wanfang database,VIP database,Pubmed,Embase,Cochrane Library on the comparison of pregnancy outcomes after LEEP versus CKC,limited to Chinese and English documents,and set the search time from 2000 to December 2020.According to the established inclusion criteria and exclusion criteria,the full text documents that meet the requirements are strictly screened,and the quality evaluation system provided by the Cochrane Collaboration is used to evaluate the quality of these included studies.Then use RevMan5.4 software to perform single rate meta-analysis and bias risk assessment on the extracted data.The set outcome observation indicators are all binary variables,and the relative risk(RR)of each outcome indicator and its 95%confidence interval(CI)are calculated.Results A total of 19 studies were included in this article,including 2 studies in English and the rest in Chinese,with a total of 2102 cases.The Meta-analysis results:the rates of premature birth(RR=2.23,95%CI:1.76-2.83,P<0.00001),premature rupture of membranes(RR=2.01,95%CI:1.50-2.71,P<0.00001),low-weight infants(RR=2.10,95%CI:1.55-2.85,P<0.00001),and postoperative complications(RR=2.75,95%CI:1.47-5.16,P<0.05)in the CKC group were higher than those in the LEEP group;the differences between the two groups in the aspects of the pregnancy rate(RR=0.93,95%CI:0.85-1.02,P>0.05),abortion rate(RR=1.49,95%CI:0.96-2.31,P>0.05),cesarean section rate(RR=0.95,95%CI:0.85-1.06,P>0.05),and cervical laceration rate(RR=1.16,95%CI:0.42-3.21,P>0.05)were not statistically significant.Conclusions Compared with CKC,LEEP is more conducive to protecting the fertility of patients,and the risk of adverse pregnancy outcomes is lower,and it is more worthy of promotion in clinical treatment.