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Does repetitive dilatation and curettage or hysteroscopic biopsy in patients treated with progestins for endometrial hyperplasia or carcinoma affect subsequent fetomaternal outcomes? A population-based study using the National Health Insurance Research Database of Taiwan.

Authors :
Lin H
Chen WH
Chen CY
Yang YH
Lee CP
Chen KJ
Ou YC
Source :
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Feb; Vol. 164 (2), pp. 605-612. Date of Electronic Publication: 2023 Sep 18.
Publication Year :
2024

Abstract

Objective: To investigate the impact of repeated dilatation and curettage or hysteroscopic biopsy on fetomaternal outcomes in patients receiving progestin treatment for endometrial hyperplasia or early-stage carcinoma.<br />Method: This was a population-based study using the Taiwan National Health Insurance Research Database between 2009 and 2017 of women who gave birth and had a history of endometrial hyperplasia and early-stage carcinoma treated with progestins. Logistic regression analysis was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs) reflecting the association between repeated procedures and fetomaternal outcomes.<br />Results: A total of 6956 women with 8690 deliveries were identified. Compared with those who had two or fewer procedures, women who received more than two procedures had a significantly higher risk for cervical insufficiency (aOR, 5.09 [95 CI, 2.31-11.24]). Furthermore, women who had more than two procedures were prone to have adverse neonatal outcomes, including Apgar score < 7 at 1 min (aOR, 1.97 [95% CI, 1.13-3.43]) and 5 min (aOR, 3.11 [95% CI, 1.33-7.23]) and preterm delivery <32 weeks (aOR, 2.86 [95% CI, 1.50-5.45]).<br />Conclusion: Undergoing more than two procedures was associated with subsequent maternal cervical insufficiency, preterm delivery <32 weeks, and low neonatal Apgar score. Health care providers should be aware of the potential risks and balance the benefits and harms of repeated procedures.<br /> (© 2023 International Federation of Gynecology and Obstetrics.)

Details

Language :
English
ISSN :
1879-3479
Volume :
164
Issue :
2
Database :
MEDLINE
Journal :
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
Publication Type :
Academic Journal
Accession number :
37723982
Full Text :
https://doi.org/10.1002/ijgo.15108