Risk of cesarean delivery after loop electrosurgical excision procedure.
Risk of cesarean delivery after loop electrosurgical excision procedure.
复制标题
环形电外科切除手术后剖宫产的风险。
DOI：
10.1097/aog.0b013e318278f904
复制
发表时间：
2013
影响因子：
7.2
通讯作者：
Macones,GeorgeA
中科院分区：
文献类型：
--
作者：
Frey,HeatherA;Stout,MollyJ;Odibo,AnthonyO;Stamilio,DavidM;Cahill,AlisonG;Roehl,KimberlyA;Macones,GeorgeA
OBJECTIVE:To estimate whether previous loop electrosurgical excision procedure (LEEP) affects the risk of cesarean delivery.METHODS:A secondary analysis of a multicenter retrospective cohort study was performed. Women who underwent a prior LEEP were compared with two unexposed cohorts: 1) women with prior screening cervical cytology only; and 2) women with prior cervical punch biopsy. The pregnancy evaluated in this analysis was the first pregnancy of a duration more than 20 weeks of gestation after the identifying cervical procedure. Stratified and multivariable logistic regression analyses were used to control for confounding.RESULTS:Five hundred ninety-eight women with prior LEEP, 588 women with screening cytology only, and 552 women with cervical biopsy were included in this study. After adjusting for relevant confounders, similar rates of cesarean delivery were seen in women with prior LEEP (31.6%) and women with prior cervical cytology only (29.3%, adjusted odds ratio [OR] 1.06, 95% confidence interval [CI] 0.79–1.41). Likewise, no differences were found in rates of cesarean delivery when women with prior LEEP were compared with those with a prior punch biopsy (29.0%, adjusted OR 0.99, 95% CI 0.74–1.33). Among women who had a cesarean delivery, arrest of labor was the indication for cesarean delivery in a similar proportion of women in the groups (LEEP compared with cytology only, P=. 12; LEEP compared with biopsy, P=. 50). Loop electrosurgical excision procedure specimen size did not vary by delivery mode. Length of time between LEEP and subsequent pregnancy also did not influence delivery mode.CONCLUSION:Loop electrosurgical excision procedure does not affect mode of delivery in the subsequent pregnancy.LEVEL OF EVIDENCE:IIThe loop electrosurgical excision procedure is not associated with an increased risk of cesarean delivery in a subsequent pregnancy.
