The Effect of Cervical Morphological Changes on Pregnancy Outcome After Loop Electrosurgical Excision Procedure
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pregnancy Outcome
- Sponsor
- The Second Affiliated Hospital of Chongqing Medical University
- Enrollment
- 300
- Locations
- 1
- Primary Endpoint
- cone dimensions/volume
- Last Updated
- 7 years ago
Overview
Brief Summary
This study aims to assess how the proportion of the cervical volume/length removed during treatment for cervical intraepithelial neoplasia (CIN) varies and whether this correlates to the pregnancy duration at delivery
Detailed Description
The high peak age of the Cervical intraepithelial neoplasia (CIN)patients was from 25 to 35 years old, which is the best women of childbearing age, Standard treatment for CIN is called Loop electrosurgical excision procedure (LEEP),but the inappropriate conization may damage the cervical function leading to infertility, abortion, preterm delivery and dystocia. Therefore, reasonable and standard conization is very important for treating and preventing the complication. The International Federation of Cervical Pathology and Colposcopy(IFCPC) advocates the length of cervical conization should be decided by the type of cervical transformation zone, however, the cervical lengths in female are different leading to the same cervical conization lengths cause the diverse influences on the cervical function.Therefore, individualized cervical conization therapies are very needed，At present, there are still lack of objective data about cervical morphology of women at childbearing age,besides the effects of cervical morphological changes caused by LEEP on pregnancy and childbirth has not been reported. Our hypothesis is that the proportion of the cervical tissue removed is likely to influence both cervical healing and the cervical volume following surgery and as a result the risk of prematurity in subsequent pregnancies. The present prospective study investigates the variation in the proportion of the cervix removed during excisional treatment and provides pilot data on pregnancy outcomes in a sample population for which the dimensions and proportions of the cervical tissue excised are assessed at the time of treatment.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Having fertility requirements,antecedent biopsy read as
- •cervical intraepithelial neoplasia (CIN) grade 2 or 3 or microinvasive cancer
- •adenocarcinoma in situ
- •persistent CIN 1
- •antecedent pap read as
- •high grade squamous intraepithelial lesion
- •atypical glandular cells
- •persistent low grade squamous intraepithelial lesion
Exclusion Criteria
- •anatomy unsuitable for safe office loop excision based on operator judgement
- •inability to tolerate procedure under local anesthesia
- •age less than 21 years
- •refusal of consent
- •mental incapacity
- •anticoagulant or antiplatelet therapy, or known bleeding diathesis
- •use of analgesics other than over the counter medications(OTC meds include NSAIDS or Tylenol) within 7 days of scheduled LEEP.
Outcomes
Primary Outcomes
cone dimensions/volume
Time Frame: at 24months
The dimensions of the cone are measured with a measuring tape and a ruler before formalin fixation. The measurements included the length/depth, and the anteroposterior,transverse, and lateral diameters. A fluid filled volumetric cylindrical vial (tube) are subsequently used to measure the cone volume with the fluid displacement technique
pretreatment cervical dimensions/volume
Time Frame: at 24months
The dimensions and volume of the cervix before treatment are calculated by two-dimensional transvaginal sonography (2D-TVS)
Pregnancy outcome
Time Frame: up to 48 months
In the event of a pregnancy, the prenatal management and outcomes are recorded. More specifically, it is recorded whether interventions such as cervical length ultrasound, cervical cerclage, or progesterone are used. The duration of pregnancy at delivery, the birth weight, and other obstetric outcomes and complications are recorded.
posttreatment cervical dimensions/volume
Time Frame: up to 12months
Assessment of the cervical dimensions and the cervical volume is repeated 1,3,6,12 months post-treatment follow-up visit, using the same imaging technique as that used pretreatment