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Evolution obstétricale des femmes ayant subi une conisation au laser pour dysplasie de haut grade

Hardy, Valentine
(2021)

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Hardy_Valentine_81391700_2020-2021.pdf
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Details

Supervisors
Luyckx, Mathieu
Faculty
Faculté de médecine et médecine dentaire
Degree label
Master [180] en médecine
Abstract
SCIENTIFIC SUMMARY  INTRODUCTION Treatment of high-grade dysplastic lesions by laser conization appears to correlate with a higher rate of preterm birth and obstetric complications in subsequent pregnancies.  METHODS   Retrospective analysis of a group of 643 patients who underwent laser conization for high-grade dysplasia at the University Clinics of Saint-Luc of Woluwé from 2010 to 2018. Selection of factors  potentially influencing the obstetrical outcomes: age, smoking and the cone depth. Estimation of the normality of the data by "Sharpiro-Wilk Test". Use of the "Kruskall-Wallis Test" to evaluate the influence of the cone depth on the risk of prematurity. Analysis of the influence of age and smoking on the prematurity rate by the "Dunnett's Test", with a control by the "Tukey's Test" for age. Multivariate analysis to determine the influence of factors together. RESULTS   After revision of the 643 records, 68 pregnancies were selected for statistical analysis. No analysis  showed statistically significant results, no influence of age, smoking and cone depth was  demonstrated. Women with CIN treatment have a higher risk for prematurity (less than 37 weeks (15% vs. 5.4%),  between 35 and 32 weeks (9% vs. 1.4%)), compared to the general population. Obstetrical  complications such as threatened preterm delivery (26.5% vs 3.2%), premature rupture of the amniotic sac (9% vs 3.4%), cerclage (5% vs 0.7%), chorioamninitis (7.5% vs 1.1%), and delivery haemorrhage  (5.5% vs 4.1%) were also increased after conization.  CONCLUSION Women who had conization for high-grade dysplasia have a higher risk of prematurity and obstetric  complications. However, the results should be interpreted with caution due to the small size of the  obstetric cohort and the influence of many biases, which make it impossible to obtain statistically  valid results.