Pregnancy Outcome Following Treatment of Premalignant Lesion of the Cervix in Southeast Nigeria; A Retrospective...

Area of Science:

• Gynecology
• Obstetrics
• Reproductive Health

Background:

• Cervical pre-cancer treatments, including ablative and excisional therapies, may impact future pregnancy outcomes.
• Understanding these impacts is crucial for developing interventions to support women who have undergone treatment.

Purpose of the Study:

• To investigate the effect of cervical pre-cancer treatment on second-trimester miscarriages and preterm births.
• To identify specific treatment modalities and intervals associated with adverse pregnancy outcomes.

Main Methods:

• A matched case-control study involving 373 women with pregnancies post-treatment and 373 controls.
• Statistical analysis included McNemar Chi-square and conditional logistic regression.

Main Results:

• Women treated for cervical pre-cancer had higher rates of second-trimester miscarriage (AOR: 2.05) and preterm birth (AOR: 2.74).
• Large loop excision of the transformation zone (LLETZ) significantly increased odds of miscarriage (AOR: 1.22) and preterm birth (AOR: 2.98).
• A treatment-to-pregnancy interval of ≥ 12 months was associated with reduced odds of both miscarriage (AOR: 0.605) and preterm birth (AOR: 0.484). Cryotherapy and thermocoagulation were not linked to increased risks.

Conclusions:

• LLETZ treatment for cervical pre-cancer is associated with increased risks of second-trimester miscarriage and preterm birth.
• A waiting period of at least 12 months post-treatment before conception can mitigate these risks.
• Ablative therapies appear safe regarding miscarriage and preterm birth, offering guidance for treatment choices in women of childbearing potential.