OBSTETRICAL PROGNOSIS FOR CARBON-DIOXIDE LASER CONIZATION OF THE UTERINE CERVIX

Carbon dioxide laser conisation is a very reliable surgical technique for cervical intraepithelial dysplasia. As cervical morphology and fun ction are better preserved than with other techniques, obstetrical mor bidity should be lower in the often young and pauciparous women who un dergo this procedure. In our study comparing the course of 71 pregnanc ies (55 children) in 54 operated women with that of 82 pregnancies (59 children) in these same women before conisation, the rates for compli cations at the beginning of pregnancy were similar (respectively, 14.1 % and 13.4%, early spontaneous abortions; 2.8% and 2.4%, extrauterine pregnancies; and no late spontaneous abortions). The increased risks o f premature delivery (13.2% vs. 8.5%), chorioamnionitis (1.9% vs. O%), premature rupture of membranes (1.9% vs. 0%) and prematurity (11.3% v s. 1.7%) were not statistically significant. Only the percentage of na tural term births was significantly reduced (73.6% vs. 90%; P = 0.025) , but this difference was no longer apparent after correction for the prevalence of associated obstetrical pathologies and prematurity and/o r cesarean factors which was significantly greater for the 53 pregnanc ies that developed after carbon dioxide laser conisation.