[Pregnancy outcome after excision therapy of cervical precancerous lesions]

Since inception, screening programs that use Papanicolaou smear tests have decreased the incidence of cervical cancer up to 50% in the developed countries. The unprecedented success of this program hinges not only on the sensitivity of the Papanicolaou smear test, but also on the ability to eliminate successfully the precancerous lesions that are detected by the screening test. Cervical precancerous lesions are encountered most commonly among women of reproductive age; a peak incidence occurs among women in their twenties. Because of the 5-12% chance of progression to squamous cell cancer, management guidelines recommend aggressive treatment for women with moderate-to-severe lesions. Because many women in this age group have not yet completed childbearing at the time of diagnosis, treatment for these cervical abnormalities has potentially significant reproductive consequences. This review will summarize a part of the published literature regarding the effects of excision therapies of the uterine cervix and the risk of spontaneous abortion and preterm delivery (PTD) in future pregnancies and provide some reasonable treatment recommendations for women with cervical dysplasia.