Factors Influencing Postoperative Morbidity in Women Undergoing Excisional Procedures of the Cervix [09H]. (May 2020)

• Record Type: Journal Article
• Authors: Davis, William; Bilbao, Michelle; O'Laughlin, Andie; Fleischer, Lindsay; Gabriel, Cosette; Aikins, James
• Is Part Of: Obstetrics and gynecology. Volume 135(2020)Supplement 1
• Publication Date: 2020-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000665012.18872.88
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Pain, discharge, and bleeding are common after excisional procedures of the cervix. While generally benign, they can herald complications. Our hypothesis was that age, prophylactic antibiotics, smoking and/or diabetes might be associated with these postoperative concerns. METHODS: Medical records for women undergoing excisional or ablative procedures of the cervix at Cooper University Hospital from January 2013 to December 2018 were reviewed. There were 621 total subjects. Seventy-eight were excluded due to inadequate follow-up, yielding 543 analyzable procedures. Records were reviewed for pain, discharge, and bleeding. Subsequent interventions were then recorded. Age, smoking status, procedure type, prophylactic vaginal metronidazole usage (off-label) as well as smoking and diabetic history were collected. Descriptive data are reported as such, and proportions were analyzed via chi-squared tests. RESULTS: The average age of our subjects was 40.28 years (median 36.9, standard deviation 12.4). In total, 208 women re-presented with at least one postoperative concern following their procedure. Of these, 103 required intervention. Procedure type, postoperative prophylactic antibiotic usage (n=38), age greater than the median, and active smoking status (n=115) failed to predict postoperative complications. Former smokers (n=129, P= .047) did report more concerns, although they did not require more interventions ( P= .14). CONCLUSION: Excisional and ablative procedures of the cervix are essential for the prevention of cervical cancer in patients with moderate to severe cervical dysplasia. Postoperative complaints of pain, bleeding and discharge are common and bothersome for patients. Based on our retrospective review, age, prophylactic vaginal metronidazole, smoking and diabetes were not associated with worse postoperative outcomes.