Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis
Abstract
Background Conservative methods to treat cervical intraepithelial neoplasia and microinvasive cervical cancer are commonly used in young women because of the advent of effective screening programmes. In a meta-analysis, we investigated the effect of these procedures on subsequent fertility and pregnancy outcomes. Methods We searched for studies in MEDLINE and EMBASE and classified them by the conservative method used and the outcome measure studied regarding both fertility and pregnancy. Pooled relative risks and 95% CIs were calculated with a random-effects model and interstudy heterogeneity was assessed with Cochrane's Q test. Findings We identified 27 studies. Cold knife conisation was significantly associated with preterm delivery ( Interpretation All the excisional procedures to treat cervical intraepithelial neoplasia present similar pregnancy-related morbidity without apparent neonatal morbidity. Caution in the treatment of young women with mild cervical abnormalities should be recommended. Clinicians now have the evidence base to counsel women appropriately.
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The risk of prematurity in subsequent pregnancies increases with increasing treatment radicality and length of cone excised.
“The risk of prematurity in subsequent pregnancies has been known to increase with increasing treatment radicality and length of cone excised.”
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- Authors
- Kyrgiou, M., Koliopoulos, G., Martin-Hirsch, P., Arbyn, M., Prendiville, W., & Paraskevaidis, E.
- Affiliations
- Lancashire Teaching Hospitals NHS Foundation Trust (GB)
- John Radcliffe Hospital (GB)
- Institut Scientifique de Santé Publique (BE)
- Coombe Women & Infants University Hospital (IE)
- University Hospital of Ioannina (GR)
- Corresponding author
- Kyrgiou, M
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2006-02
- Volume
- 367
- Issue
- 9509
- Pages
- 489-498
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2153952034
- Cited by
- 1,120
- References
- 3
- Citations by year
- 2026: 19 · 2025: 19 · 2024: 24 · 2023: 38 · 2022: 48 · 2021: 47 · 2020: 27 · 2019: 40 · 2018: 43 · 2017: 54 · 2016: 76 · 2015: 58 · 2014: 69 · 2013: 98 · 2012: 78
- FWCI
- 9.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- cervical intraepithelial neoplasia, microinvasive cervical cancer, conservative treatment, LLETZ, fertility, pregnancy outcomes, preterm birth, low birth weight, cesarean section, premature rupture of membranes, neonatal intensive care admission, perinatal mortality, cervical cancer screening, young women
- MeSH terms
- Adult, Birth Weight, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Female, Fertility, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Neoplastic, Pregnancy Outcome, Conization, Delivery, Obstetric, Laser Therapy
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