Loop electrosurgical excision of the cervix and the subsequent risk of preterm delivery
To investigate the association between loop electrosurgical excision procedure (LEEP) and other potential risk factors, and subsequent preterm delivery (<37 weeks), using data from a large cohort study of Danish women.
The Danish prospective cohort study was initiated in 1991, with the original aim of investigating the role of human papillomavirus in the natural history of cervical neoplasia. The study included 11,088 women aged 20-29. The cohort was invited for 2 follow-up examinations in 1993-1995 and 1999-2000, respectively. At all 3 examinations, the women answered questions about a number of different lifestyle variables. We assessed the relationship between preterm delivery and potential risk factors, such as previous LEEP treatments, smoking during pregnancy, age, parity and previous preterm delivery. The cohort was followed until 2004, through linkages with the nationwide Pathology Data Bank and the Medical Birth Registry.
Of the 14,982 deliveries in the cohort during follow up, 542 were preterm (21-37 weeks). Among deliveries with no previous LEEP, 3.5% ended as a preterm delivery, whereas this applied to 6.6% among deliveries following a LEEP, yielding a significantly increased risk of preterm birth after LEEP (OR=1.8; 95% CI: 1.1-2.9). The strongest risk factor for preterm delivery was a previous preterm delivery (OR=2.3; 95% CI: 1.4-3.7). Other significant risk factors were smoking during pregnancy and low educational status.
Our study showed an almost 2-fold increase in the risk of preterm delivery after LEEP treatment. Thus, women in their reproductive age should be informed about the increased risk of preterm delivery, if treated with LEEP.
Available from: Keun Young Lee
- "Early studies on the impact of conization on pregnancy are hindered by small study population, inadequately powered study design, and neglect of potential confounders such as socioeconomic status and previous preterm delivery. (Sadler et al., 2007)Recent welldesigned studies with large sample sizes conclude that conization increases the risk of preterm birth and perinatal morbidities (Jakobsson et al., 2007; Sjoborg et al., 2007; Nohr et al., 2007) Jakobsson et al. (Jakobsson et al., 2007) found a significant increase of very preterm birth (28-31 weeks) and extremely preterm birth (< 28 weeks) following conization. [relative risk (RR) 1.99, 95% confidence interval (CI) 1.81-2.20; "
Hysterectomy, 04/2012; , ISBN: 978-953-51-0434-6
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ABSTRACT: The aim of this study is to develop a method to predict unexplained syncope or presyncope occurrences. Diagnosis of syncope is currently based on the reproduction of symptoms in combination with hypotension and bradycardia induced by a 45-min of 60-80° head-upright tilt test (HUTT). The main drawback of this test concerns its duration which can reach 55 minutes if the patient does not faint. Thus we propose a new predicting tool which is only based on the 10 first minutes of the supine position of the HUTT. First, we describe how to acquire the variables of the disease and to achieve the dimension reduction methods. Then, at the end of the variables processing a neuronal method evaluates the prediction quality for a retrospective and a prospective group of patients. The best model compares very favorably with previous published results for other syncope detectors.
Signal Processing and Its Applications, 2005. Proceedings of the Eighth International Symposium on; 02/2005
Acta Obstetricia Et Gynecologica Scandinavica 02/2007; 86(11):1286-9. DOI:10.1080/00016340701698781 · 2.43 Impact Factor
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