The Clinical Course of Pregnancy and Delivery Following Photofrin Photodynamic Therapy for Cervical Intraepithelial Neoplasia 3: Comparison with Cervix Conization

Abstract

Since 2004, our hospital has performed photofrin photodynamic therapy (PDT) on 81 patients with cervical intraepithelial neoplasia 3 of the uterine cervix. No patients displayed recurrence after photofrin PDT. Of these patients, 27 became pregnant, with a total gravidity of 46. This study retrospectively reports the perinatal prognosis of pregnancy in 21 patients following photofrin PDT and compares it to that in 17 patients following cervix conization who delivered at our hospital. Following cervix conization in primipara, premature labor rate and emergency caesarean section rate increased, and following cervix conization in multipara, the gestational age at birth decreased. Conversely, following photofrin PDT in primipara, the premature labor rate was low, but bleeding during childbirth increased. No significant difference was identified in the partograph; therefore we compared the partograph with Friedman’s curve. Furthermore, following photofrin PDT, the premonitory stage of labor was prolonged, but the first stage of labor was not prolonged. Conversely, following cervix conization, the duration of labor decreased with Friedman’s curve. In our hospital, pregnancies following photofrin PDT were generally favorable, without premature delivery. Additionally, the emergency cesarean section rate was low for deliveries following photofrin PDT. However, care is necessary because there is an increase in bleeding during childbirth following photofrin PDT. We aim to have a safe perinatal prognosis following photofrin PDT to ensure its continuity in future.