Pregnancy outcomes and associated factors of patients undergoing cervical conization

Background The need for pregnancy in patients with high grade squamous intraepithelial lesion after conization is increasing year by year, while there is no clinical consensus on the treatment and postoperative management of patients with fertility needs.

Objective To study the effect of conization of cervix on pregnancy outcomes in patients with high grade squamous intraepithelial lesion and analyze the risk factors for adverse pregnancy outcomes (preterm birth, cesarean section, low birth weight).

Methods A retrospective analysis was performed on 65 patients who underwent conization of cervix in the First Medical Center of Chinese PLA General Hospital from September 1, 2017 to December 31, 2021, and the patients were served as the observation group. Another 65 patients who gave birth at the Obstetrics Department of Chinese PLA General Hospital during the same period were collected as the control group. The general information (age, height, weight) and pregnancy outcome (preterm birth, mode of delivery) of the observation group and the control group were compared. The observation group was divided into two groups based on whether the conization height (pathological results) was greater than 1.5 cm. The general data and the pregnancy outcomes such as premature birth and cesarean section rate of the two groups were compared, and the factors associated with adverse pregnancy outcomes after conization were explored.

Results The rate of preterm pregnancy after cervical conization was changed (P＜0.05). There was no significant difference in the rate of cesarean section and the incidence of premature birth when the height of conization was greater than 1.5 cm (P＞0.05). Conization height greater than 1.5 cm was associated with adverse pregnancy outcomes after cervical conization (OR=3.868, 95% CI: 1.256-11.918).

Conclusion The preterm birth rate of pregnancy increases after electrosurgical coning of cervix. For patients with fertility requirements, the height of conization should not exceed 1.5 cm under the premise of removing the lesion, and pregnancy should be reserved after half a year of surgery. Strict monitoring of the pregnancy process and necessary cervical cerclage can avoid adverse pregnancy events.