| ObjectiveDiscussion conization impact on patients’fertility and its related pregnancy outcome.MethodsEight-six cases of cervical lesions in our hospital to implement cervical conization surgery patients from January 1,2008 to May 31,2013 admitted to follow-up,no primary infertility before surgery, fertility requirements of 45 patients, as the experimental group;no random sample of cervical cone art history cut from the same period in 5864 cases of obstetrics and gynecology clinic patients, fertility requirements of women over 50 cases as control group. Conization method currently used mainly two kinds, cervical loop electrosurgical excision(LEEP)and Cervical cold knife conization(CKC).After a review of relevant medical records medical record room, And in our hospital and patients are not in our hospital childbirth telephone follow-up:Including the general situation of the two groups of patients, age, height, weight, gestational history, production history, history of abnormal pregnancy, cervical conization height, whether from the cervix after pregnancy interval, whether during pregnancy miscarriage row hospitalized during pregnancy cervical cerclage, pregnancy outcomes (miscarriage, premature birth, pre-term labor, premature rupture of membranes) and manner of termination of pregnancy (cesarean birth)Results1.Patients generally compare Generally conization patients and control groups were compared, no significant difference (P> 0.05).2. Comparison of pregnancy Conization group of 45 patients,40 patients were 41 pregnancies, the pregnancy rate was 88.8%(40/45); Control group,46 patients were 47 pregnancies, the pregnancy rate was 92.0%(46/50), compared two groups of pregnancy, no significant difference (P> 0.05).3. Pregnancy outcomes(1)effect on miscarriage, premature delivery, premature rupture of membranes Conization group of 36 patients had preterm labor patients three cases (8.3%); control group,42 cases have been two cases of preterm labor patients, the incidence of 4.8%(2/42). Conization group 3 cases of premature rupture of membranes, the rate was 8.3%(3/36); one case of premature rupture of membranes in the control group, the rate was 2.3% (1/42). Conization group of 40 patients have been pregnant patients,5 cases of abortion, the abortion rate 12.5 (5/40); the control group of 46 patients have been pregnant patients,5 cases of abortion, the abortion rate 10.9 (5/46). Conization group miscarriage, premature labor, premature rupture of membranes occurred was clearly higher, but no significant difference (P> 0.05).(2)conization height relationship with pregnancy outcome and cervical cerclage Conization group of 40 cases of pregnant women will have conization height according to<10mm,10-20mm, ≥1Omm divided into three groups, three groups of patients in the abortion rate, the rate of preterm birth, premature rupture of membranes and cesarean section rate with the rate of cervical height increase conization increases, but three two groups, no significant difference (P> 0.05); 36 cases have been delivery in 2 patients routine cervical cerclage, cervical conization were two patients height) 20mm, one patient was cold knife conization cervical cone height of 30mm. Conization≥20mm height is an important factor in patients with cervical cerclage.(3)Relationship between cervical conization pregnancy interval and Pregnancy Outcome Conization group cervical conization pregnancy interval minimum of 4 months and a maximum of 48 months, the patients were cervical conization distance pregnancy interval divided into three groups, namely<6 month group,6--12 month group and ≥ December group. Distance after pregnancy intervals shorter than six months in the preterm group were significantly higher than more than 12 months, has significant difference(P=0.0014). Comparison of the three groups in the abortion rate and cesarean section rate, no significant difference (P> 0.05).(4)Relations conization and hospital treatment of miscarriage 36 patients with cervical conization group had childbirth, including 14 cases during pregnancy because of "miscarriage" and hospitalization, miscarriage rate was 38.8 (14/36). The control group patients have birth 42 patients,3 patients hospitalized in different periods of pregnancy miscarriage, miscarriage rate was 7.1%(3/42). Conization group is higher, has significant difference (P=0.001).4. Effect of perinatal children children were no neonatal deaths, the cervical cone cutting group compared with control group, neonatal birth weight is lower than the control group,has significant difference (P=0.027).5. The manner of termination of pregnancy(1)Conization group cesarean section rate is higher, has significant difference (P=0.028); cases have been delivery, vaginal trial production success rate than the control group, but no significant difference (P> 0.05). Conization increased surgical indications in patients with psychosocial factors, patients were indications for surgery to remove the social and psychological factors, the rate of caesarean section are basically the same.(2)Comparison of two cesarean section Conization group psychosocial factors indications for surgery was significantly higher, has significant difference (P=0.037). Remaining aspects of cesarean section, but no significant difference (P> 0.05).Conclusion1. Cervical conization no significant effect on the ability of patients with cervical lesions in pregnancy.2. Conization no significant effect on miscarriage, premature birth, the incidence of premature rupture of membranes. Influences.3. conization highly associated with adverse perinatal outcomes no significant relationship, but conization≥20mm height is an important factor in patients with cervical cerclage.4. The rate of preterm birth in patients with pregnancy intervals shorter than 6 months was significantly higher than in patients with pregnancy intervals greater than 12 months.5. conization increased miscarriage rate of hospitalization during pregnancy.6. conization did not result in an increase in neonatal mortality, but birth weight was significantly reduced.7. conization in patients with vaginal delivery did not have a successful trial production was significantly affected, but significant increase in the rate of cesarean section and increased social and psychological factors that cesarean section, no increase in other aspects of cesarean section. |
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