Pregnancy outcome following loop electrosurgical excision procedure (LEEP) a systematic review and meta-analysis

Abstract

LEEP is associated with an increased risk of subsequent preterm delivery (<32/34, <28 weeks) and other serious pregnancy outcomes. But increasing LEEP volume or depth is not associated with an increased rate of preterm birth.

Kinderwunsch und Schwangerschaft bei Zervixkarzinom und Vorstufen

“…Trimenon in allen nachfolgenden Schwangerschaften und perinataler Mortalität assoziiert sowie mit Fehlgeburten [4,7,8]. Das Risiko einer Frühgeburtlichkeit ist auf das 1,4-bis 7Facher erhöht (6,5-25 % aller Geburten nach Konisation) [9].…”

Pregnancy Outcome after the Treatment of Loop Electrosurgical Excision Procedure or Cold-Knife Conization for Cervical Intraepithelial Neoplasia

“…Given this retrospective study with relatively fewer convincible measurements, it was possible that there was not enough power to detect a significant difference in pregnancy outcome between them. Other previous studies either only regarding one treatment method or with a small number of cases showed various but conflicting results [4,5,6,7,8,9]. Nonetheless, one study even affirmed that the diagnosis of precancerous changes in the cervix, regardless of the treatment, was often associated with an increased risk of preterm birth [10].…”

“…At present there are two main therapeutic strategies to treat CIN, namely the loop electrosurgical excision procedure (LEEP) and cold-knife conization (CKC). However, both procedures for the treatment of CIN have been associated with adverse outcomes in subsequent pregnancies, including preterm delivery, preterm premature rupture of membranes (PPROM), cesarean delivery, low birth weight (LBW) infants, and cervical stenosis [4,5,6]. For those women who wish to have children later in life, it is important not to compromise pregnancies by surgical interventions on the cervix.…”

Using novel biomarkers to triage young adult women with minor cervical lesions: a cost‐effectiveness analysis

“…Women may also experience anxiety from the procedure itself, or from awaiting and receiving test results. In addition, diagnostic colposcopy-directed biopsy may cause pain, bleeding, or discharge [29], and treatment of cervical precancer is associated with an increased risk of preterm birth and other adverse pregnancy outcomes [30,31]. The majority of precancers would never have progressed to cancer in the absence of treatment [22] yet available technologies cannot distinguish between precancers that will progress to CC from those likely to regress; consequently, CC screening involves some over-treatment.…”

“…The general aim of this thesis is to inform decision-makers about the health benefits, resource use and cost-effectiveness of current and future CC screening policies in Norway. Specifically, the four papers in this thesis evaluate: (i) the short-term health and economic outcomes of using novel biomarkers to triage younger (i.e., aged [25][26][27][28][29][30][31][32][33] years) unvaccinated women with minor cervical cytological lesions, (ii) the most costeffective strategy to triage unvaccinated women with minor cervical cytological lesions, (iii) the trade-offs in health benefits and resource use associated with adopting primary HPV DNA testing strategies for unvaccinated women, and (iv) the most cost-effective CC screening strategies for women vaccinated against HPV-infections in adolescence.…”