Pregnancy outcome after loop electrosurgical excision procedure for cervical intraepithelial neoplasia

Abstract

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Objective: To determine pregnancy outcomes among women who underwent loop electrosurgical excision procedure (LEEP). Methods: In a case-control study in Italy, 475 pregnant women who underwent LEEP and 441 untreated pregnant women were enrolled between January 2003 and January 2007. Outcome measures were spontaneous abortion, preterm delivery, and at-term delivery rates. Continuous and discrete variables were analyzed via t, χ 2 , and Fisher exact tests. Groups were compared by analysis of variance and Tukey HSD test. Results: The spontaneous abortion rate was 14.5% and 14.1% in the LEEP and untreated groups, respectively. The preterm delivery rate was 6.4% and 5.0% in the LEEP and untreated groups, respectively. The number of women with a cervical length of less than 30 mm was higher in the LEEP group, but this did not influence preterm delivery rate (odds ratio [OR], 1.01; 95% confidence interval [CI], 0.53-1.95). Among women with a cervical length of less than 15 mm, those treated with a wider removal of cervical tissue showed increased risk of preterm delivery (OR, 5.31; 95% CI, 1.01-28.07). Conclusion: The preterm delivery rate was not higher among women who underwent LEEP than among untreated women. Preterm delivery was associated with cone size and cervical length in the second trimester.

Outcomes and predictive tests from a dedicated specialist clinic for women at high risk of preterm labour: A ten year audit

“…The finding of a poorer PPV for a short cervix in women with a past history of cervical surgery is particularly important in light of previous studies that have found an increased rate of midtrimester short cervix in this population . Although it has been reported that the volume of cervical tissue excised for the biopsy may elevate the risk of SPTB, other studies conclude that the increased risk is independent of the presence of the mean shorter cervical length found in this group of women …”

Cervical length as a predictor for spontaneous preterm birth in high-risk singleton pregnancy: current knowledge

“…Other studies in this group of women used only a single measure of CL, and many reported CL < 30 mm, rather than < 25 mm, as being significant for SPTB prediction. If the cause of SPTB in women with previous excisional cervical surgery was indeed due to loss of cervical volume, then the CL predicting SPTB ought to be shorter than in women with different risk factors for SPTB.…”

Clinical and Immunologic Biomarkers for Histologic Regression of High-Grade Cervical Dysplasia and Clearance of HPV16 and HPV18 after Immunotherapy

“…4,5). While effective, such interventions have a number of undesirable possible side effects including pain and cervical incompetence leading to preterm birth and low infant birthweight (6,7). Moreover, even successful procedures of this nature may not clear infection by high-risk HPV (HR-HPV), thus leaving the patient at risk for recurrence of disease (8)(9)(10).…”