Effects of loop electrosurgical excision procedure or cold knife conization on pregnancy outcomes

Purpose: To explore the effects of cervical loop electrosurgical excision procedure (LEEP) or cold knife conization (CKC) on pregnancy outcomes. Materials and Methods: Patients with cervical intraepithelial neoplasia (CIN) who wanted to become pregnant and received LEEP or CKC were considered as the treatment groups. Women who wanted to become pregnant and only underwent colposcopic biopsy without any treatments were considered as the control group. The pregnancy outcomes were observed and compared in the three groups. Results: Premature delivery rate was higher (p = 0.048) in the CKC group (14 / 36, 38.88%) than in control group (14 / 68, 20.5%) with a odds ratio (OR) of 2.455 (1.007 - 5.985); and premature delivery was related to cone depth, OR was significantly increased when the cone depth was more than 15 mm. There was no significant difference in premature delivery between LEEP (10 / 48, 20.83%) and the control groups. The average gestational weeks were shorter (p = 0.049) in the CKC group (36.9 ± 2.4) than in the control group (37.8 ± 2.6), but similar in LEEP (38.1 ± 2.4) and control groups. There were no significant differences in cesarean sections between the three groups. The ratio of neonatal birth weight less than 2,500 g was significantly higher (p = 0.005) in the CKC group (15/36) than in the control group (10/68), but similar in the LEEP and control groups. Conclusion: Compared with CKC, LEEP is relatively safe. LEEP should be a priority in the treatment of patients with CIN who want to become pregnant.

Conization of cervix; Cervical loop electrosurgical excision procedure; Cervical cold knife conization; Cervical intraepithelial neoplasia; Pregnancy outcomes.

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