The incidence of preterm labor after large loop excision of the transformation zone of the cervix

الملخص EN

Objective : To assess whether patients who have a prior history of Large Loop Excision of the Transformation Zone of the Cervix are at increased risk of subsequent preterm labor.

Study Design : Retrospective cohort study using information obtained from hospital computerized obstetric database.

Setting: The Coombe Women's Hospital in Dublin, which is the largest single provider of women's healthcare in Ireland.

The hospital also incorporates the country's busiest colposcopy service.

Subjects and Methods: Records were obtained for all women who delivered at the hospital during a forty-four month period between October 1999 and June 2003.

All cases of preterm delivery were identified and examined.

Statistical comparisons were made between patients with a prior history of Large Loop Excision of the Transformation Zone and those without (control population) for outcome measures.

Main Outcome Measures: Incidence of preterm labor defined as less than 37 weeks' completed gestation.

Other outcome measures were the incidence of confirmed preterm pre-labor spontaneous rupture of the membranes in the index pregnancy.

Results: During the period studied, 27497 women were delivered at the hospital.

Among those, 359 (1.3 %) had at least one Large Loop Excision of the Transformation Zone procedure in the past.

The incidence of preterm labor in the Large Loop Excision of the Transformation Zone group was 12.53 %, as compared to 4.93 % in the control group (p < 0.0001).

The incidence of preterm pre-labor spontaneous rupture of the membranes in the Large Loop Excision of the Transformation Zone group was not statistically significantly different when compared with the control group.

Conclusion: Prior history of Large Loop Excision of the Transformation Zone of the cervix is associated with an increased risk of preterm labor and delivery in a subsequent pregnancy.

This is not related to an increased incidence of preterm pre-labor spontaneous rupture of the membranes.