Features of childbirth and the postpartum period in women who have undergone destructive treatments for cervical pathology
Authors: Kostyuk I. Yu. 
Published: July 2021

In the complex mechanism that controls the onset of labor, there are many factors, among which an important role belongs to the cervix, so to reduce the risk and development of obstetric and perinatal complications, the problems of timely diagnosis and adequate treatment of cervical diseases are still relevant today.The objective: еvaluate the features of childbirth and the postpartum period in women who have undergone destructive treatments for cervical pathology.Materials and methods. All examined women (n=201) after destructive methods of treatment of the cervix for dysplasia of I–III degree (electroconization, cryodestruction, laser vaporization or radiowave excision) were divided into 3 groups: 1 group (retrospective, n=114) – patients, in which features of childbirth and the postpartum period were studied anamnestically; 2 group (prospective, n=57) – women who were included in the study immediately after surgery; 3 group (control, n=30) – almost healthy women. Patients in the comparative groups were comparable in age (mean age 25,7±4.4 years) and the course of the pathological process in the cervix.Results. During the 5 years of the study, the peculiarities of the course of childbirth, the condition of newborns and the postpartum period in patients after surgery were studied. In the 1st group of subjects 114 pregnancies were registered, of which 97 ended in childbirth: naturally – in 66 women (57,9%), cesarean section – in 31 (27,2%). The main complications in childbirth were weakness of labor (44 patients – 45,4%), fetal hypoxia (41 patients – 42,3%), premature birth (36 patients – 37,1%).In the 2nd group of women 57 pregnancies were registered (50 births): naturally – in 7 patients (12,3%), cesarean section – in 43 women (75,4%). The most common complication in this group was placenta previa (6 cases – 12,0%).In the control group, 30 pregnancies (27 births) were registered: in 22 women (73,3%) by natural means, in 5 (16,7%) – by cesarean section. The most common complications of childbirth in this group were weakness of labor (4 cases – 14,8%), bleeding in the postpartum period (3 patients – 11,1%) and hypoxia of the fetus (3 cases – 11,1%).The high percentage of women in group 1 who were diagnosed with ruptures of the cervix of varying severity (the largest in patients after electroconization), in groups 2 and 3, isolated cases were noted.In all three groups, more than half of the newborns had normal body weight (3000 to 4000 g) and a high Apgar score (8 to 9 points).Conclusion. In the analysis of childbirth in women of the three study groups, it was found that compared with somatically healthy women (group 3) in patients after destructive treatment of cervical pathology (groups 1 and 2) there is a decrease in the proportion of births through natural routes (73,3%, 57,9% and 12,3%, respectively) and an increase in the proportion of births by cesarean section (16,7%, 27,2% and 75,4%). The highest percentage of surgical interventions was recorded in the first two groups in women after amputation and conization of the cervix, the lowest – in patients after laser vaporization and radiosurgical excision. Therefore, these methods of destruction of the cervix are the least traumatic, can cure the underlying disease and preserve reproductive function.