Fertility and early pregnancy outcomes following conservative treatment for cervical intraepithelial neoplasia and early cervical cancer
A partir d'une revue de la littérature publiée entre 1948 et 2015 (15 études), cette étude analyse les effets des traitements conservateurs localisés sur la fertilité et l'évolution de la grossesse chez patientes atteintes de néoplasies cervicales intraépithéliales ou d'un cancer invasif du col de l'utérus de stade précoce
Clinical Question : Does local conservative treatment for cervical intraepithelial neoplasia and early invasive cervical cancer adversely affect successful conception and early pregnancy outcomes in the first and second trimester (<24 weeks of gestation)? Clinical Application : Local cervical treatment does not adversely affect fertility or first trimester miscarriage, although it is associated with a significant increase in the risk of second trimester miscarriages. The mean age of women undergoing treatment for preinvasive cervical disease is similar to the age of women having their first child. Local conservative treatment for cervical intraepithelial neoplasia (CIN) and early invasive cervical cancer has been associated with increased risk of preterm birth, neonatal morbidity and mortality.1,2 Although the effect of treatment on obstetric outcomes has been extensively assessed, there are relatively few studies exploring the effect of treatment on the ability to conceive and early pregnancy outcomes. This clinical evidence synopsis summarizes a Cochrane Systematic Review3,4 comparing the fertility and early pregnancy outcomes up to 24 weeks of gestation in women with a history of treatment vs those that have not received treatment