A combination of second trimester oral metronidazole and no sexual intercourse during second and third trimester may reduce late miscarriage and premature delivery after fertility sparing radical trachelectomy
(2021) In European Journal of Obstetrics and Gynecology and Reproductive Biology 265. p.90-95- Abstract
Objectives: Women with a previous trachelectomy have an increased risk of premature delivery and second trimester miscarriage. In this study we aim to evaluate factors and regimes possibly affecting the risk for prematurity following fertility sparing robotic radical trachelectomy (RRT) in cervical cancer. Methods: A retrospective study of the reproductive outcome following RRT with a cervical cerclage performed at one of four academic centers between 2007 and 2019. Factors possibly related to premature delivery, such as postoperative non-pregnant cervical length, previous vaginal deliveries, preservation of the uterine arteries, and the use of a second trimester oral metronidazole/no sexual intercourse regime, were assessed. Results:... (More)
Objectives: Women with a previous trachelectomy have an increased risk of premature delivery and second trimester miscarriage. In this study we aim to evaluate factors and regimes possibly affecting the risk for prematurity following fertility sparing robotic radical trachelectomy (RRT) in cervical cancer. Methods: A retrospective study of the reproductive outcome following RRT with a cervical cerclage performed at one of four academic centers between 2007 and 2019. Factors possibly related to premature delivery, such as postoperative non-pregnant cervical length, previous vaginal deliveries, preservation of the uterine arteries, and the use of a second trimester oral metronidazole/no sexual intercourse regime, were assessed. Results: 109 women remained for analyses after excluding recurrences before pregnancy (n = 8), secondary hysterectomy (n = 2), and women with less than six months follow up (n = 10). 74 pregnancies occurred in 52/71 women attempting to conceive, 56 of which developed past the first trimester. Two of 22 women (9%) who were prescribed an oral metronidazole regime (400 mg × 2 from gestational week 15 + 0 to 21 + 6 and abstaining from sexual intercourse for the duration of the pregnancy) had a premature delivery, compared with 13/31 (42%) where the regime was not applied (p = 0.009). The association remained after regression analyses including possible contributing factors as of above, none of which associated with prematurity at regression analyses (p = 0.001). Conclusions: The observed four-fold reduction in premature delivery indicates that an oral metronidazole/no sexual intercourse regime may reduce second trimester miscarriage and premature deliveries following an RRT. No association was observed for other investigated factors.
(Less)
- author
- Ekdahl, Linnea LU ; Eoh, Kyung Jin ; Thumuluru, Kavitha Madhuri ; Butler-Manuel, Simon A. ; Tae Kim, Young ; Lönnerfors, Celine LU ; Falconer, Henrik and Persson, Jan LU
- organization
- publishing date
- 2021-10
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cervical cancer, Metronidazole, Radical trachelectomy, Reduced risk of premature deliveries
- in
- European Journal of Obstetrics and Gynecology and Reproductive Biology
- volume
- 265
- pages
- 6 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85113844608
- pmid:34474227
- ISSN
- 0301-2115
- DOI
- 10.1016/j.ejogrb.2021.08.019
- language
- English
- LU publication?
- yes
- id
- 4f85181b-96c8-488e-9350-09ef3616792a
- date added to LUP
- 2021-09-17 14:51:26
- date last changed
- 2024-09-22 01:27:26
@article{4f85181b-96c8-488e-9350-09ef3616792a, abstract = {{<p>Objectives: Women with a previous trachelectomy have an increased risk of premature delivery and second trimester miscarriage. In this study we aim to evaluate factors and regimes possibly affecting the risk for prematurity following fertility sparing robotic radical trachelectomy (RRT) in cervical cancer. Methods: A retrospective study of the reproductive outcome following RRT with a cervical cerclage performed at one of four academic centers between 2007 and 2019. Factors possibly related to premature delivery, such as postoperative non-pregnant cervical length, previous vaginal deliveries, preservation of the uterine arteries, and the use of a second trimester oral metronidazole/no sexual intercourse regime, were assessed. Results: 109 women remained for analyses after excluding recurrences before pregnancy (n = 8), secondary hysterectomy (n = 2), and women with less than six months follow up (n = 10). 74 pregnancies occurred in 52/71 women attempting to conceive, 56 of which developed past the first trimester. Two of 22 women (9%) who were prescribed an oral metronidazole regime (400 mg × 2 from gestational week 15 + 0 to 21 + 6 and abstaining from sexual intercourse for the duration of the pregnancy) had a premature delivery, compared with 13/31 (42%) where the regime was not applied (p = 0.009). The association remained after regression analyses including possible contributing factors as of above, none of which associated with prematurity at regression analyses (p = 0.001). Conclusions: The observed four-fold reduction in premature delivery indicates that an oral metronidazole/no sexual intercourse regime may reduce second trimester miscarriage and premature deliveries following an RRT. No association was observed for other investigated factors.</p>}}, author = {{Ekdahl, Linnea and Eoh, Kyung Jin and Thumuluru, Kavitha Madhuri and Butler-Manuel, Simon A. and Tae Kim, Young and Lönnerfors, Celine and Falconer, Henrik and Persson, Jan}}, issn = {{0301-2115}}, keywords = {{Cervical cancer; Metronidazole; Radical trachelectomy; Reduced risk of premature deliveries}}, language = {{eng}}, pages = {{90--95}}, publisher = {{Elsevier}}, series = {{European Journal of Obstetrics and Gynecology and Reproductive Biology}}, title = {{A combination of second trimester oral metronidazole and no sexual intercourse during second and third trimester may reduce late miscarriage and premature delivery after fertility sparing radical trachelectomy}}, url = {{http://dx.doi.org/10.1016/j.ejogrb.2021.08.019}}, doi = {{10.1016/j.ejogrb.2021.08.019}}, volume = {{265}}, year = {{2021}}, }