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How endocervicoscopy can impact obstetric outcomes in women undergoing LEEP for CIN2 + : a retrospective cohort analysis

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To assess the impact of preoperative endocervicoscopy on obstetric outcomes and complications in women undergoing LEEP for CIN2 + .

Methods

This was a retrospective cohort study carried out between October 2012 and April 2018. All women had undergone cervical length measurement at T0 (before LEEP), T1 (6 months after LEEP), and T2 (at 20 weeks of pregnancy) through transvaginal ultrasound examination after LEEP for CIN2 + . A total of 528 patients fulfilled our inclusion criteria and contributed to the final analysis: 288 had undergone endocervicoscopy before the excisional procedure (Group A), while the remaining 240 (Group B) did not.

Results

Patients who did not undergo endocervicoscopy showed a greater amount of tissue excised at LEEP compared to those of Group A (6.7% vs 31.9% in Group A and B, p < 0.01, respectively). A statistically relevant difference was detected in the lesion margins involvement: negative in 93.8% in Group A compared to 65.6% in Group B. The cervicometry before the treatment resulted in similar between the two groups, while a statistically significant difference was noted after 6 months (37.5 ± 2.9 mm in Group A vs 35.1 ± 3.8 mm in Group B, p < 0.01) and at 20th week pregnancy (36.9 ± 5.3 mm in Group A vs 33.5 ± 5.6 mm in Group B, p < 0.01). The number of pregnancies after LEEP as well as the difference in the elapsed time (in months) did not result in a statistical significance between the two groups. The threatened preterm labor (TPL) and the threatened miscarriage showed a statistically significant difference in incidence between the two groups (4,2% and 4.2% in Group A vs 15.3% and 25% in Group B, p < 0.01, respectively).

Conclusion

Endocervicoscopy reduces the size of the LEEP sample and in particular its depth, saving healthy cervical tissue, and guarantees the total eradication of the lesion as the resection margins are negative in almost all cases, allowing for a reduction of the rate of TPL and threatened miscarriage in women with CIN2 + , especially with Type 2 or 3 cervical squamocolumnar junction (SCJ).

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Data statement

Data are available upon request by the corresponding author.

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Funding

No financial support was received for this study.

Author information

Author notes

  1. Luigi Della Corte and Giada Lavitola have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131, Naples, Italy

    Luigi Della Corte

  2. Department of Public Health, University of Naples Federico II, 80131, Naples, Italy

    Giada Lavitola & Giuseppe Bifulco

Authors
  1. Luigi Della Corte
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  2. Giada Lavitola
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  3. Giuseppe Bifulco
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Contributions

Conception and design: LDC and GL. Analysis and/or interpretation of the data: LDC. Drafting of the article: LDC and GD. Critical revision of the article for important intellectual content: LDC, GL, and GB. Final approval of the article: LDC, GL, and GB. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Luigi Della Corte.

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Conflict of interest

Dr. Della Corte, Dr. Lavitola, and Prof. Bifulco have no conflicts of interest or financial conflicts to disclose.

Ethical approval

All procedures performed in the study 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.

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Informed consent was obtained from all individual participants included in the study.

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Della Corte, L., Lavitola, G. & Bifulco, G. How endocervicoscopy can impact obstetric outcomes in women undergoing LEEP for CIN2 + : a retrospective cohort analysis. Arch Gynecol Obstet 308, 507–513 (2023). https://doi.org/10.1007/s00404-023-07087-5

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  • DOI: https://doi.org/10.1007/s00404-023-07087-5

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