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Laser vaporization of the cervix is associated with an increased risk of preterm birth and rapid labor progression in subsequent pregnancies

Abstract

Purpose

Laser vaporization of the cervix is an established method of treating cervical intra-epithelial neoplasia, but its effect on subsequent pregnancies remains controversial. The aim of this study was to investigate pregnancy outcomes after laser vaporization.

Methods

We conducted a retrospective study involving women who delivered live singletons between 2012 and 2019 in a tertiary hospital. The risks of adverse pregnancy outcomes after laser vaporization of the cervix were assessed using a multivariate regression model. The primary outcome was the adjusted odds ratio for preterm births. We also evaluated the course of labor progression, duration of labor, risk of emergency cesarean deliveries, and the risk of cervical laceration as secondary outcomes.

Results

In total, 3359 women were analyzed in this study. The risk of preterm birth was significantly higher in pregnancies after laser vaporization of the cervix (adjusted odds ratio [AOR] 1.84, 95% confidence interval [95% CI] 1.06–3.20; p = 0.030). The duration of the first stage of labor was significantly shorter in the post-treatment group (median 255 min vs. 355 min; p = 0.0049). We did not observe significant differences in the duration of the second stage of labor (median 21 min vs 20 min; p = 0.507) or the rates of other obstetric events, including emergency cesarean deliveries (AOR 0.736; 95% CI 0.36–1.50; p = 0.400) and cervical laceration (AOR 0.717; 95% CI 0.22–2.35; p = 0.582).

Conclusion

Laser vaporization of the cervix is associated with an increased risk of preterm births and a shorter duration of the first stage of labor in subsequent pregnancies. Careful consideration is necessary when selecting a method of treatment for the uterine cervix of patients wishing future pregnancies.

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Data availability

The data analyzed in this study is available in the Mendely repository, https://data.mendeley.com/datasets/zdzg6vg8ty/3.

Abbreviations

AOR:

Adjusted odds ratio

BMI:

Body mass index

CIN:

Cervical intraepithelial neoplasia

COR:

Crude odds ratio

NICU:

Neonatal intensive care unit

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

No funding was received.

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Affiliations

Authors

Contributions

KN: Project development, data analysis, manuscript writing. YF: Manuscript editing. DT, NM and ST: data collection. TS: Data collection, data management. All authors approved the final manuscript.

Corresponding author

Correspondence to Kenta Nitahara.

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Conflict of interest

There is no conflict of interest to be declared.

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This retrospective study was performed after obtaining approval from the institutional ethics committee of Miyazaki Prefectural Miyazaki Hospital (Approval number: 19-58). Because of the retrospective nature of the study and the anonymization of the collected data, patient consent was waivered by the committee.

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Nitahara, K., Fujita, Y., Tanaka, D. et al. Laser vaporization of the cervix is associated with an increased risk of preterm birth and rapid labor progression in subsequent pregnancies. Arch Gynecol Obstet 304, 895–902 (2021). https://doi.org/10.1007/s00404-021-06025-7

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Keywords

  • Laser vaporization of the cervix
  • Cervical conization
  • Cervical intraepithelial neoplasia
  • Preterm births
  • Labor progression