The effect of the delivery mode on the evolution of cervical intraepithelial lesions during pregnancy. A meta-analysis.
Cervical dysplasia
Cervical intraepithelial neoplasia
Delivery mode
Route of delivery
Squamous intraepithelial lesion
Journal
Journal of gynecology obstetrics and human reproduction
ISSN: 2468-7847
Titre abrégé: J Gynecol Obstet Hum Reprod
Pays: France
ID NLM: 101701588
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
20
06
2022
revised:
19
08
2022
accepted:
23
08
2022
pubmed:
28
8
2022
medline:
2
12
2022
entrez:
27
8
2022
Statut:
ppublish
Résumé
The aim of the present study was to evaluate the impact of the mode of delivery on the natural evolution of cervical squamous intraepithelial lesions in pregnant patients. Α systematic search was conducted in Medline (1966-2021), Cochrane Central Register of Controlled Trials CENTRAL (1999-2021), Scopus (2004-2021), Google Scholar (2004-2021) and Clinicaltrials.gov (2008-2021) along with the reference lists of electronically retrieved full-text papers. All the studies that investigated the correlation of the mode of delivery with the natural evolution of cervical squamous intraepithelial lesions of patients during pregnancy, were included in the present meta-analysis. Eight retrospective studies were finally included, comprising 813 patients whose premalignant lesions were evaluated cytologically, of whom 685 delivered via the vaginal route, and 233 patients whose squamous intraepithelial lesions were evaluated histologically, of whom 162 delivered vaginally. The methodological quality of the included studies ranged between moderate and serious. Regression rates were comparable among women that delivered with caesarean section compared to patients that delivered vaginally, both in the cytological (OR 1.32, 95% CI 0.56, 3.12) and in the histological evaluation (OR 1.87, 95% CI 0.50, 6.96) of the lesions. Subgroup analysis revealed consistent results for all subgroups of premalignant lesions. Finally, the results observed for both the persistence and the progression rates of these lesions were proportional. Our meta-analysis suggests that the delivery mode does not alter the natural evolution of squamous intraepithelial lesions in pregnant women and therefore their presence should not determine the mode of delivery.
Identifiants
pubmed: 36029957
pii: S2468-7847(22)00146-5
doi: 10.1016/j.jogoh.2022.102462
pii:
doi:
Types de publication
Meta-Analysis
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
102462Informations de copyright
Copyright © 2022. Published by Elsevier Masson SAS.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no conflicts of interest to disclose.