Mehmet Obut, Can Tekin İskender, Aykut Kından, Özge Yücel Çelik, Mevlüt Bucak, Fulya Kayıkçıoğlu, Betül Tokgöz Çakır, Sevgi Koç, Caner Çakır, Şevki Çelen, Ali Turhan Çağlar, Yaprak Engin Üstün
{"title":"影响因 CIN 2 或 CIN 3 而接受冷刀和环形电切术锥切术的患者产科结果的因素。","authors":"Mehmet Obut, Can Tekin İskender, Aykut Kından, Özge Yücel Çelik, Mevlüt Bucak, Fulya Kayıkçıoğlu, Betül Tokgöz Çakır, Sevgi Koç, Caner Çakır, Şevki Çelen, Ali Turhan Çağlar, Yaprak Engin Üstün","doi":"10.4274/jtgga.galenos.2023.2023-1-15","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine factors affecting obstetric outcomes in pregnancies after conization by loop electrosurgical excision procedure (LEEP) or cold-knife conization (CKC) due to cervical intraepithelial neoplasia (CIN).</p><p><strong>Material and methods: </strong>The maternal and clinical characteristics and obstetric outcomes of CKC, LEEP and control groups were evaluated and compared. Risk factors for adverse pregnancy outcomes were evaluated using multiple logistic regression analyses.</p><p><strong>Results: </strong>The incidence of preterm delivery, PPROM, low APGAR scores, fetal mortality, and late-period spontaneous abortus was highest in patients who underwent CKC (p<0.05). Cone depth of CKC was longer than LEEP (p=0.025). Cervical length (CL) at pregnancy was CKC<LEEP<controls (p=0.003). Shorter CL at pregnancy and time from conization to pregnancy (t-CP) was correlated with a high incidence of preterm delivery and PPROM (p<0.05). To predict preterm delivery, t-CP <14 months had 63.16% sensitivity and 77.42% specificity (AUC=0.714, 95% CI: [0.603-0.809]; p=0.005), and CL at pregnancy <31 mm had 65% sensitivity and 71.78% specificity (AUC=0.731, 95% CI: [0.675-0.782]; p<0.001). To predict PPROM, t-CP <15 months had 85.71% sensitivity and 65.22% specificity (AUC=0.730, 95% CI: [0.603-0.809]; p=0.024), and CL <32 mm had 72.73% sensitivity and 61.89% spcificity (AUC=0.685, 95% CI: [0.675-0.782,p=0.007).</p><p><strong>Conclusion: </strong>Compared with CKC, LEEP has shorter cone depth and fewer adverse pregnancy outcomes. The t-CP<14 months was a risk for preterm delivery and <15 months was a risk for PPROM. CL at pregnancy <31 mm was a risk for preterm delivery and <32 mm was a risk for PPROM.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Affecting Obstetric Outcomes in Patients Who Underwent Cold-Knife and Loop Electrosurgical Excision Procedure Conization Due to CIN 2 or CIN 3.\",\"authors\":\"Mehmet Obut, Can Tekin İskender, Aykut Kından, Özge Yücel Çelik, Mevlüt Bucak, Fulya Kayıkçıoğlu, Betül Tokgöz Çakır, Sevgi Koç, Caner Çakır, Şevki Çelen, Ali Turhan Çağlar, Yaprak Engin Üstün\",\"doi\":\"10.4274/jtgga.galenos.2023.2023-1-15\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine factors affecting obstetric outcomes in pregnancies after conization by loop electrosurgical excision procedure (LEEP) or cold-knife conization (CKC) due to cervical intraepithelial neoplasia (CIN).</p><p><strong>Material and methods: </strong>The maternal and clinical characteristics and obstetric outcomes of CKC, LEEP and control groups were evaluated and compared. Risk factors for adverse pregnancy outcomes were evaluated using multiple logistic regression analyses.</p><p><strong>Results: </strong>The incidence of preterm delivery, PPROM, low APGAR scores, fetal mortality, and late-period spontaneous abortus was highest in patients who underwent CKC (p<0.05). Cone depth of CKC was longer than LEEP (p=0.025). Cervical length (CL) at pregnancy was CKC<LEEP<controls (p=0.003). Shorter CL at pregnancy and time from conization to pregnancy (t-CP) was correlated with a high incidence of preterm delivery and PPROM (p<0.05). To predict preterm delivery, t-CP <14 months had 63.16% sensitivity and 77.42% specificity (AUC=0.714, 95% CI: [0.603-0.809]; p=0.005), and CL at pregnancy <31 mm had 65% sensitivity and 71.78% specificity (AUC=0.731, 95% CI: [0.675-0.782]; p<0.001). To predict PPROM, t-CP <15 months had 85.71% sensitivity and 65.22% specificity (AUC=0.730, 95% CI: [0.603-0.809]; p=0.024), and CL <32 mm had 72.73% sensitivity and 61.89% spcificity (AUC=0.685, 95% CI: [0.675-0.782,p=0.007).</p><p><strong>Conclusion: </strong>Compared with CKC, LEEP has shorter cone depth and fewer adverse pregnancy outcomes. The t-CP<14 months was a risk for preterm delivery and <15 months was a risk for PPROM. CL at pregnancy <31 mm was a risk for preterm delivery and <32 mm was a risk for PPROM.</p>\",\"PeriodicalId\":17440,\"journal\":{\"name\":\"Journal of the Turkish German Gynecological Association\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2023-12-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Turkish German Gynecological Association\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4274/jtgga.galenos.2023.2023-1-15\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Turkish German Gynecological Association","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4274/jtgga.galenos.2023.2023-1-15","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Factors Affecting Obstetric Outcomes in Patients Who Underwent Cold-Knife and Loop Electrosurgical Excision Procedure Conization Due to CIN 2 or CIN 3.
Objective: To determine factors affecting obstetric outcomes in pregnancies after conization by loop electrosurgical excision procedure (LEEP) or cold-knife conization (CKC) due to cervical intraepithelial neoplasia (CIN).
Material and methods: The maternal and clinical characteristics and obstetric outcomes of CKC, LEEP and control groups were evaluated and compared. Risk factors for adverse pregnancy outcomes were evaluated using multiple logistic regression analyses.
Results: The incidence of preterm delivery, PPROM, low APGAR scores, fetal mortality, and late-period spontaneous abortus was highest in patients who underwent CKC (p<0.05). Cone depth of CKC was longer than LEEP (p=0.025). Cervical length (CL) at pregnancy was CKC
Conclusion: Compared with CKC, LEEP has shorter cone depth and fewer adverse pregnancy outcomes. The t-CP<14 months was a risk for preterm delivery and <15 months was a risk for PPROM. CL at pregnancy <31 mm was a risk for preterm delivery and <32 mm was a risk for PPROM.
期刊介绍：
Journal of the Turkish-German Gynecological Association is the official, open access publication of the Turkish-German Gynecological Education and Research Foundation and Turkish-German Gynecological Association and is published quarterly on March, June, September and December. It is an independent peer-reviewed international journal printed in English language. Manuscripts are reviewed in accordance with “double-blind peer review” process for both reviewers and authors. The target audience of Journal of the Turkish-German Gynecological Association includes gynecologists and primary care physicians interested in gynecology practice. It publishes original works on all aspects of obstertrics and gynecology. The aim of Journal of the Turkish-German Gynecological Association is to publish high quality original research articles. In addition to research articles, reviews, editorials, letters to the editor, diagnostic puzzle are also published. Suggestions for new books are also welcomed. Journal of the Turkish-German Gynecological Association does not charge any fee for article submission or processing.
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