This Article Full Text (PDF) All Versions of this Article: 1933719109339349v1 16/11/1034    most recent References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Ueda, Y. Articles by Kimura, T. PubMed PubMed Citation Articles by Ueda, Y. Articles by Enomoto, T. Articles by Miyatake, T. Articles by Yoshino, K. Articles by Fujita, M. Articles by Miyake, T. Articles by Fujiwara, K. Articles by Muraji, M. Articles by Kanagawa, T. Articles by Kimura, T. Social Bookmarking                         What's this?

Postpartum Outcome of Cervical Intraepithelial Neoplasia in Pregnant Women Determined by Route of Delivery

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Takayuki Enomoto, MD, PhD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan, enomoto{at}gyne.med.osaka-u.ac.jp

Takashi Miyatake, MD, PhD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Kiyoshi Yoshino, MD, PhD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Masami Fujita, MD, PhD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Takahito Miyake, MD, PhD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Kazuko Fujiwara, MD, PhD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Miho Muraji, MD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Takeshi Kanagawa, MD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Tadashi Kimura, MD, PhD

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

Cervical intraepithelial neoplasia (CIN) has its highest incidence during women’s reproductive years. During 2 sequential 7-year periods, 1994 to 2000 and 2001 to 2007, 3695 and 3894 deliveries were performed, respectively, at Osaka University Hospital. CIN was detected in 21 cases (0.57%) during 1994-2000 and in 43 cases (1.1%) during 2001-2007. By comparison, cervical intraepithelial neoplasia—complicated pregnancies increased significantly in the latter period (P = .015 by Fisher exact test, Odds ratio = 1.95; 95%CI: 1.16-3.30). We observed CIN regression in 34 (76%) of 45 cases of vaginal delivery and in 6 (50%) of 12 cases of cesarean delivery, indicating that the outcome of an initially diagnosed CIN and the delivery routes appeared not to be significantly related. However, a different result was obtained when only those patients whose CIN lesions persisted until the delivery were analyzed. Among the 35 such cases in the vaginal delivery group, 24 cases (69%) regressed after the delivery; in 8 such cases from the cesarean delivery group, only 2 cases (25%) regressed afterward. Our study clearly shows that pregnancy complicated with CIN is increasing rapidly in Japan. We also find that there is a significantly more frequent postpartum regression of biopsy-proven CIN lesions following a vaginal delivery compared to cesarean section (P = .042 by Fisher exact test, Odds ratio = 6.55; 95% CI: 1.13-37.8).

Key Words: CIN • pregnancy • outcome • delivery route.

This version was published on November 1, 2009

Reproductive Sciences, Vol. 16, No. 11, 1034-1039 (2009)
DOI: 10.1177/1933719109339349


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?