LA PREVENZIONE ED IL TRATTAMENTO DELLE PATOLOGIE HPV-CORRELATE: FOLLOW-UP E PERFORMANCE RIPRODUTTIVA

Abstract

Relationship between HPV-infection and reproductive performance includes patients who during trial become pregnant. Main chapter indeed represents genital lesions treatments sequelae. Clinical phase 3 studies showed that spontaneous abortion rate in both groups (Gardasil and placebo respectively) was comparable (33% vs 31.6%). Moreover, there were 25 cases of congenital abnormalities among newborns and live foetuses, and congenital abnormalities global rate was similar than normal population. Therefore, there is no evidence that Gardasil adversely influences fertility, pregnancy and neonatal outcome. Cold-cut conization, laser-conization, laser-ablation, LEEP or LLETZ are conservative techniques that can treat with efficacy invasive cervical cancer. Neverthless, outcome data relative to successive pregnancies are discordant. LLETZ is associated to greater risk of early childbirth, low-weight birth and PROM. Similar results are obtained with laser-conization. Also cold-cut conization is significatively associated with incremented risk of early childbirth, low-weight and caesarean section.