LEEP sonrası doğum yapan 51 kadın çalışma grubuna,
geçirilmiş servikal cerrahi öyküsü olmayan ve kliniğimizde
doğum yapan 60 kadın ise kontrol grubuna alındı.
111 kadının doğumdaki gebelik haftaları üç grupta
toplandı; preterm (doğumdaki gebelik haftası 37 hafta
altı), term (doğumdaki gebelik haftası 37 ile 42 hafta
arası) ve post term (doğumdaki gebelik haftası 42 hafta
ve üstü). Çalışma grubu ile kontrol grubu doğumdaki
ortalama gebelik haftaları ve erken doğum oranları
açısından karşılaştırıldı.
Çalışma ve kontrol grubundaki kadınların doğumdaki
gebelik haftaları 35 hafta 2 gün ile 42 hafta 4 gün
arasında değişmekle birlikte ortalaması 39.03 ±
1.39’dur. Çalışma ve kontrol grubunun doğumdaki
ortalama gebelik haftası sırasıyla; 38.97 ± 1.38 ve
39.08 ± 1.42’dir(p=0,684). Çalışma grubundaki
olguların % 7.8’inde, kontrol grubundakilerin ise %
6.7’sinde preterm doğum gerçekleşmiştir(p=0,969).
Hem doğumdaki ortalama gebelik haftaları hemde
preterm doğum oranları açısından gruplar arasında
anlamlı bir istatistiksel farklılık yoktur(p>0,05).
LEEP uygulamasının, doğumdaki ortalama gebelik
haftasını etkilemediği ve erken doğum riskini artırmadığı
sonucuna varılmıştır.
SUMMARY
To investigate whether Loop Electrosurgical Excision
Procedure(LEEP) application increases the risk of premature
birth in women of reproductive age.
51 women who gave birth after LEEP were taken to study
group and 60 women who had no history of previous
cervical surgery and gave birth in our clinic were included in
the control group. The gestational age of 111 women were
gathered in three groups; preterm (gestational age at birth
less than 37 weeks), term (gestational age at birth between
37-42 weeks) and post term (gestational age at birth 42
weeks and above). The study group and the control group
were compared in terms of medial gestational age at birth
and premature birth delivery rates.
The medial gestational age of the women in the study and
control groups ranged from 35 weeks and 2 days to 42 weeks
and 4 days and the average is 39.03 ± 1.39. The medial
gestational age at birth of the study and control group is as
follows; 38.97± 1.38 and 39.08 ± 1.42(p=0,684). Preterm
birth was observed in 7.8% of the cases in the study group
and 6.7% in the control group(p=0,969). No significant
statistical difference is observed between the groups in terms
of both the medial gestational age and the preterm birth
rates(p>0,05).
It was concluded that the LEEP application does not affect
the medial gestational age and does not increase the risk of
premature birth.
1. Gonzalez Sanchez JL, Perez Guerro C, Celorio Aguilera G, at al. Cytologic correlation between the Bethesda system and colposcopic biopsy. Gynecol Obstet. Mex. Aug. 66: 330-4. 1998
2. Quinn M., Babb P., Jones J., at al. Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics. BMJ 1999; 318: pp. 904-908
3. Prendiville W., Cullimore J., and Norman S. Large loop excision of the transformation zone (LLETZ). A new method of management for women with cervical intraepithelial neoplasia. Br J Obstet Gynaecol 1989; 96: pp. 1054-1060
4. Wright T.C, Cox J.T., Massad L.S. et al. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia. Am J Obstet Gynecol 2003; 189: pp. 295-304
5. Turligton WT, Wright BD, Powell JL. İmpact of loop electrosurgical excision procedure on future fertility. J. Reprod. Med. 41: 815-81. 1996
6. Ganesh Acharya, Ingvild Kjeldberg, Sidsel Mordt Hansen, at al. Arch Gynecol Obstet. 272; 109-12. 2005 7. Althuisius SM, Schornagel IJ, Dekker GA, at al. Loop electrosurgical excision procedure of the cervix and time of delivery in subsequent pregnancy. Int J Gnecol Obstet 72: 31-34. 2001
8. Tan L, Pepra E, Haloob RK. The outcome of pregnancy after large loop excision of the transformation zone of the cervix. J Obstet Gynecol 24: 25-27. 2004
9. Ferenczy A, Choukroun D, Falcone T, at al. The effect of cervical loop electrosurgical excision on subsequent pregnancy outcome: North American experience. Am J Obstet Gynecol 172: 1246-50. 1995
10. Paraskevaidis E, Koliopoulos G, Lolis E, at al. Delivery outcomes following loop electrosurgical excision procedure for microinvasive(FIGO stage IA1) cervical cancer. Gynecol Oncol. 86: 10-13. 2002
11. Samson SL, Bentley JR, Fahey TJ, at al. The effect of loop electrosurgical excision procedure on future pregnancy outcome. Obstet Gynecol. Feb; 105(2): 325- 32. 2005
12. Noehr B, Jensen A, Frederiksen K, at al. Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population- based study of singleton deliveries during a 9-year period. Am J Obstet Gynecol. Apr 3. 2009
13. Crane J. Pregnancy outcome after loop electrosurgical excision procedure: a systematic review. Obstet Gynecol Nov; 102: 1058-62. 2003
14. Antonio F, Francesco S, Luana DS, at al. Pregnancy outcome after loop electrosurgical excision procedure
for cervical intraepithelial neoplasia. Int Journel of Gynecol and Obs 122(2):145-49. 2013
15. Nora A. Danhof a, *, Esme I. Kamphuis a , Jacqueline Limpens b , Luc R.C.W. van Lonkhuijzen a , Eva Pajkrt a , Ben W.J. Mol. European Journal of Obstetrics & Gynecology and Reproductive Biology 188 (2015) 24–33
16. In Horner M.J., Ries L.A., and Krapcho M. (eds): SEER cancer statistics review.
17. Coppell K., and Cox B.: An evaluation of the National Cervical Screening Programe Otago site. N Z Med J 2000; 113: pp. 48-51
18. Ljubojevic N., Babic S., Audy-Jurkovic S., et al: Loop excision of the transformation zone (LETZ) as an outpatient method of management for women with cervical intraepithelial neoplasia. BJOG 1997; 104: pp. 1325-1326
19. Keijser K.G.G., Kenemans P., van der Zanden P.H.T.H., et al: Diathermy loop excision in the management of cervical intra-epithelial neoplasia. Am J Obstet Gynecol 1992; 166: pp. 1281-1287
20. Mitchell M.F., Tortolero-Luna G., Cook E., at al. A randomized clinical trial of cryotherapy, laser vaporization, and loop electrosurgical excision for treatment of squamous intraepithelial lesions of the cervix. Obstet Gynecol 1998; 92:pp.737-744
21.MathevetP.,DargentD.,RoyM.,atal.Arandomized study comparing three techniques of conization:cold knife cone, laser, and LEEP.Gynecol Oncol 1994; 54: pp.175-9
22. Sadler L., Saftlas A., Wang W., at al. Treatment for cervical intraepithelial neoplasia and risk of preterm delivery. JAMA 2004; 291: pp. 2100-2106
23. Jakobsson M., Gissler M., Paavonen J., at al. Loop electrosurgical excision procedure and the risk for preterm birth. Obstet Gynecol 2009; 114: pp. 504-510