Desfecho da gravidez e do parto em mulheres submetidas a conização cervical.

Resumo

The purpose of this study was to assess the effect of cervical conization on subsequent pregnancy and delivery outcomes. METHOD/STUDY DESIGN: We used a retrospective design that included the records of all women who had conization of the cervix in our department between March 1st 1993 and September 1st 2001. Loop electrosurgical excision procedure (LEEP) was performed in every woman. From the totality of records we selected the ones who subsequently got pregnant (20 patients) and determined the pregnancy and delivery events.113 women in the reproductive years underwent cervical conization during this period; 45 (39.8%) were lost to follow up, 48 (42.5%) didn't get pregnant and 20 (11.7%) women achieved 21 pregnancies. Among these 21 pregnancies there were 2 (9.5%) spontaneous abortions, 2 (9.5%) voluntary terminations of pregnancies, 1 (4.8%) elective termination of pregnancy, 1 (4.8%) ectopic pregnancy, 1 (4.8%) pregnancy evolving in the first trimester at the time of the study and 14 (66.7%) term deliveries. This last group was studied with more detail. Half of the women were nulliparous and half were multiparous. There were 2 cases of threatened preterm labour, 2 gestation diabetes, 1 pregnancy induced hypertension, 1 intrauterine growth restriction, 1 macrosomic foetus, 1 premature rupture of membranes and in three cases the labour was induced. The mean time between conization and delivery was 35.75 months. All deliveries occurred between 37 and 40 weeks of gestation; 11 (78.6%) women delivered vaginally and 3 (21.4%) had caesarean section. Only one newborn weighted less than 2500 g. The mean duration of labour (active phase of the first stage and 2nd stage) was 130.92 minutes (95 minutes for multiparous and 157.5 minutes for nulliparous women).Despite the small number of cases, pregnant patients who previously underwent LEEP don't seem to be at increased risk of adverse pregnancy outcome, preterm delivery, caesarean delivery or low birth weight. There was, however, a tendency to short duration of labour.