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
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. Method This was a population‐based study using the Taiwan National Health Insuranc...
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| Veröffentlicht in: | International journal of gynecology and obstetrics 2024-02, Vol.164 (2), p.605-612 |
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| container_title | International journal of gynecology and obstetrics |
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| creator | Lin, Hao Chen, Wen‐Hsin Chen, Chao‐Yu Yang, Yao‐Hsu Lee, Chuan‐Pin Chen, Ko‐Jung Ou, Yu‐Che |
| description | 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.
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.
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 |
| doi_str_mv | 10.1002/ijgo.15108 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2866378843</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2866378843</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2888-585db02d4b998691b2382daaee9de37935c6d94c0d2dd7e246dca86d55338a943</originalsourceid><addsrcrecordid>eNp9ks1u1DAUhQMC0aGwgAdAd4mQpiTOn7NCVQvtoIpKqKyjG_tmxlXGDr4Oo-x4BJ6RJ8EzU1iy8uKe890fnyR5naVnWZqK9-Z-7c6yMkvl42SRybpZ5kXdPEkWsZgua9GIk-Q5832aplmdZc-Sk7yuRd5IsXj06tIRg6eRggnmB4E2AwYMxllAq0FNnkLANYHzsJk5kHes3GgUdMaNPIOxMEY92cAQPGEgDTsTNjB6tyYOxjL00UxWuy0Fb3CIoJH8OCAb3HMVemWs2yJg35MKwFPH9H2KTOgpxEJsa6PPTUFFCH-AcxjdOA2HQX___NUhx7YcJj3DxMauIWwIvhzK0XdNOMSJVpYnj1YRfCWm2HQDl3HZvRlcD3dodmhfJE97HJhePrynybdPH-8urpc3t1eri_ObpRJSymUpS92lQhdd08iqyTqRS6ERiRpNed3kpap0U6hUC61rEkWlFcpKl2WeS2yK_DR5e-TGO8VVObRbw4qGAS25iVshqyqvpSzyKH13lKp4fPbUt6M3W_Rzm6XtPgLtPgLtIQJR_OaBO3Vb0v-kf_88CrKjYGcGmv-Dalefr26P0D8bssXf</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2866378843</pqid></control><display><type>article</type><title>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</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Lin, Hao ; Chen, Wen‐Hsin ; Chen, Chao‐Yu ; Yang, Yao‐Hsu ; Lee, Chuan‐Pin ; Chen, Ko‐Jung ; Ou, Yu‐Che</creator><creatorcontrib>Lin, Hao ; Chen, Wen‐Hsin ; Chen, Chao‐Yu ; Yang, Yao‐Hsu ; Lee, Chuan‐Pin ; Chen, Ko‐Jung ; Ou, Yu‐Che</creatorcontrib><description>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.
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.
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]).
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.
Synopsis
Repeated dilatation and curettage or hysteroscopic biopsy in progestin‐treated patients with endometrial hyperplasia or early‐stage carcinoma increases the risk of cervical insufficiency, preterm delivery, and low Apgar score.</description><identifier>ISSN: 0020-7292</identifier><identifier>EISSN: 1879-3479</identifier><identifier>DOI: 10.1002/ijgo.15108</identifier><identifier>PMID: 37723982</identifier><language>eng</language><publisher>United States</publisher><subject>Biopsy ; Carcinoma ; Dilatation and Curettage ; endometrial carcinoma ; endometrial hyperplasia ; Endometrial Hyperplasia - pathology ; Endometrial Neoplasms - pathology ; Female ; fetomaternal outcomes ; Humans ; Infant, Newborn ; Premature Birth - epidemiology ; progestin treatment ; Progestins ; Taiwan</subject><ispartof>International journal of gynecology and obstetrics, 2024-02, Vol.164 (2), p.605-612</ispartof><rights>2023 International Federation of Gynecology and Obstetrics.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2888-585db02d4b998691b2382daaee9de37935c6d94c0d2dd7e246dca86d55338a943</cites><orcidid>0000-0002-2849-5661</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijgo.15108$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijgo.15108$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37723982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Hao</creatorcontrib><creatorcontrib>Chen, Wen‐Hsin</creatorcontrib><creatorcontrib>Chen, Chao‐Yu</creatorcontrib><creatorcontrib>Yang, Yao‐Hsu</creatorcontrib><creatorcontrib>Lee, Chuan‐Pin</creatorcontrib><creatorcontrib>Chen, Ko‐Jung</creatorcontrib><creatorcontrib>Ou, Yu‐Che</creatorcontrib><title>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</title><title>International journal of gynecology and obstetrics</title><addtitle>Int J Gynaecol Obstet</addtitle><description>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.
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.
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]).
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.
Synopsis
Repeated dilatation and curettage or hysteroscopic biopsy in progestin‐treated patients with endometrial hyperplasia or early‐stage carcinoma increases the risk of cervical insufficiency, preterm delivery, and low Apgar score.</description><subject>Biopsy</subject><subject>Carcinoma</subject><subject>Dilatation and Curettage</subject><subject>endometrial carcinoma</subject><subject>endometrial hyperplasia</subject><subject>Endometrial Hyperplasia - pathology</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Female</subject><subject>fetomaternal outcomes</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Premature Birth - epidemiology</subject><subject>progestin treatment</subject><subject>Progestins</subject><subject>Taiwan</subject><issn>0020-7292</issn><issn>1879-3479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1u1DAUhQMC0aGwgAdAd4mQpiTOn7NCVQvtoIpKqKyjG_tmxlXGDr4Oo-x4BJ6RJ8EzU1iy8uKe890fnyR5naVnWZqK9-Z-7c6yMkvl42SRybpZ5kXdPEkWsZgua9GIk-Q5832aplmdZc-Sk7yuRd5IsXj06tIRg6eRggnmB4E2AwYMxllAq0FNnkLANYHzsJk5kHes3GgUdMaNPIOxMEY92cAQPGEgDTsTNjB6tyYOxjL00UxWuy0Fb3CIoJH8OCAb3HMVemWs2yJg35MKwFPH9H2KTOgpxEJsa6PPTUFFCH-AcxjdOA2HQX___NUhx7YcJj3DxMauIWwIvhzK0XdNOMSJVpYnj1YRfCWm2HQDl3HZvRlcD3dodmhfJE97HJhePrynybdPH-8urpc3t1eri_ObpRJSymUpS92lQhdd08iqyTqRS6ERiRpNed3kpap0U6hUC61rEkWlFcpKl2WeS2yK_DR5e-TGO8VVObRbw4qGAS25iVshqyqvpSzyKH13lKp4fPbUt6M3W_Rzm6XtPgLtPgLtIQJR_OaBO3Vb0v-kf_88CrKjYGcGmv-Dalefr26P0D8bssXf</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Lin, Hao</creator><creator>Chen, Wen‐Hsin</creator><creator>Chen, Chao‐Yu</creator><creator>Yang, Yao‐Hsu</creator><creator>Lee, Chuan‐Pin</creator><creator>Chen, Ko‐Jung</creator><creator>Ou, Yu‐Che</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2849-5661</orcidid></search><sort><creationdate>202402</creationdate><title>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</title><author>Lin, Hao ; Chen, Wen‐Hsin ; Chen, Chao‐Yu ; Yang, Yao‐Hsu ; Lee, Chuan‐Pin ; Chen, Ko‐Jung ; Ou, Yu‐Che</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2888-585db02d4b998691b2382daaee9de37935c6d94c0d2dd7e246dca86d55338a943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Biopsy</topic><topic>Carcinoma</topic><topic>Dilatation and Curettage</topic><topic>endometrial carcinoma</topic><topic>endometrial hyperplasia</topic><topic>Endometrial Hyperplasia - pathology</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Female</topic><topic>fetomaternal outcomes</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Premature Birth - epidemiology</topic><topic>progestin treatment</topic><topic>Progestins</topic><topic>Taiwan</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Hao</creatorcontrib><creatorcontrib>Chen, Wen‐Hsin</creatorcontrib><creatorcontrib>Chen, Chao‐Yu</creatorcontrib><creatorcontrib>Yang, Yao‐Hsu</creatorcontrib><creatorcontrib>Lee, Chuan‐Pin</creatorcontrib><creatorcontrib>Chen, Ko‐Jung</creatorcontrib><creatorcontrib>Ou, Yu‐Che</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Hao</au><au>Chen, Wen‐Hsin</au><au>Chen, Chao‐Yu</au><au>Yang, Yao‐Hsu</au><au>Lee, Chuan‐Pin</au><au>Chen, Ko‐Jung</au><au>Ou, Yu‐Che</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>International journal of gynecology and obstetrics</jtitle><addtitle>Int J Gynaecol Obstet</addtitle><date>2024-02</date><risdate>2024</risdate><volume>164</volume><issue>2</issue><spage>605</spage><epage>612</epage><pages>605-612</pages><issn>0020-7292</issn><eissn>1879-3479</eissn><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.
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.
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]).
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.
Synopsis
Repeated dilatation and curettage or hysteroscopic biopsy in progestin‐treated patients with endometrial hyperplasia or early‐stage carcinoma increases the risk of cervical insufficiency, preterm delivery, and low Apgar score.</abstract><cop>United States</cop><pmid>37723982</pmid><doi>10.1002/ijgo.15108</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2849-5661</orcidid></addata></record> |
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| identifier | ISSN: 0020-7292 |
| ispartof | International journal of gynecology and obstetrics, 2024-02, Vol.164 (2), p.605-612 |
| issn | 0020-7292 1879-3479 |
| language | eng |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Biopsy Carcinoma Dilatation and Curettage endometrial carcinoma endometrial hyperplasia Endometrial Hyperplasia - pathology Endometrial Neoplasms - pathology Female fetomaternal outcomes Humans Infant, Newborn Premature Birth - epidemiology progestin treatment Progestins Taiwan |
| title | 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 |
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