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Aetiology/Harm
Systematic review with meta analysis
Cone depth increases risk of adverse obstetric outcomes following treatment for cervical preinvasive disease
  1. Alejandra Castanon
  1. Queen Mary University of London, London, UK
  1. Correspondence to: Dr Alejandra Castanon, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK; a.castanon{at}qmul.ac.uk
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http://dx.doi.org/10.1136/ebmed-2016-110564

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    Commentary on: Kyrgiou M, Athanasious A, Paraskevaidi M, et al. Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth: systematic review and meta-analysis. BMJ 2016;354:i3633OpenUrlAbstract/FREE Full Text.

    Context

    A strong and consistent association between treatment for cervical disease and subsequent preterm birth has been established.1 The association with preterm birth is stronger when more aggressive forms of treatment (eg, knife cones) are considered.1 Several studies have shown a biological gradient, with a greater risk of preterm delivery with increasing amount of tissue removed.2 ,3 Two meta-analyses have assessed the importance of the comparison group when assessing the risk of preterm birth,4 ,5 but they did not consider the amount of tissue removed. This systematic review and meta-analysis examines the impact of various types of treatment for cervical preinvasive disease on obstetric outcomes and how this risk could …

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