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首页> 外文期刊>Current opinion in obstetrics & gynecology >Pregnancy management after cervical surgery.
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Pregnancy management after cervical surgery.

机译：宫颈手术后的妊娠处理。

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PURPOSE OF REVIEW: An amplified risk of adverse pregnancy outcomes after excisional cervical surgery has been identified. Procedures such as cold-knife conization, laser conization, loop electrosurgical excision procedure, and trachelectomy increase the risk of preterm delivery and preterm premature rupture of membranes. Few studies have evaluated prenatal care considerations after these procedures. This review discusses pregnancy management after cervical surgery. RECENT FINDINGS: Data showing an association between excisional and ablative procedures of the cervix and subsequent preterm delivery or preterm premature rupture of membranes are increasing and include more recent information from larger case series and meta-analyses. The need for appropriate and evidence-based management strategies during subsequent pregnancy has arisen. Screening for genital tract infection, sonographic cervical length surveillance, and progesterone administration for cervical shortening may lead to improved pregnancy outcomes in women at high risk for preterm delivery, including women who have undergone cervical surgery. Modifiable risk factors such as depth of conization and procedure-to-pregnancy time interval should be recognized and clinicians should avoid overtreatment for preinvasive cervical lesions. SUMMARY: A number of procedures performed for a variety of indications can be considered excisional cervical surgery. As a result, no standard recommendations for pregnancy management following cervical surgery exist. Given the increased risk of pregnancy complications, certain screening tests or interventions may be appropriate for these women.
机译：审查目的：已经确定了宫颈切除手术后不良妊娠结局的放大风险。诸如冷刀锥切术，激光锥切术，环形电外科切除术和气管切开术之类的程序会增加早产和早产胎膜破裂的风险。很少有研究评估过这些手术后的产前护理考虑因素。这篇评论讨论了宫颈手术后的妊娠管理。最近的发现：显示子宫颈切除和消融手术与随后的早产或早产胎膜破裂之间相关性的数据正在增加，并且包括来自更大病例系列和荟萃分析的最新信息。在随后的怀孕期间，需要采取适当的，循证的管理策略。筛查生殖道感染，超声检查宫颈长度并检查黄体酮以缩短宫颈长度，可以提高早产高风险妇女（包括接受过宫颈手术的妇女）的妊娠结局。应该认识到可改变的危险因素，例如锥切深度和从怀孕到怀孕的时间间隔，临床医生应避免对浸润前宫颈病变进行过度治疗。摘要：针对各种适应症执行的许多程序可以被认为是宫颈切除术。结果，不存在宫颈手术后妊娠管理的标准建议。由于怀孕并发症的风险增加，因此某些筛查测试或干预措施可能适合这些女性。

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