Treating Cervical Lesions May Pose Pregnancy Risks

Doctors and researchers at the Central Lancashire Teaching Hospitals in Preston, Great Britain, has suggested that a popular cancer cell removal treatment may increases the risks of complications in pregnancy.

According to British researchers, women who have had this procedure – loop electro surgical excision procedure or LEEP, are in greater risk of delivering premature or low-birth-weight infants.

What is LEEP?

LEEP is one of a number of surgical procedures for removing abnormal or precancerous cells from the cervix. It is performed by numbing the cervix by local anesthesia then inserting an electrically charged wire loop through the vagina. The loop acts as a scalpel and cuts away a thin layer of tissue including the abnormal cells. Other methods include the cold knife conization, laser ablation and laser conization. All of which remove abnormal tissue or cells while preserving cervical function.

However, British doctors warn that your women with mild cervical abnormalities should use caution should they need LEEP treatment. "Women should seek detailed information on efficacy but also on long-term pregnancy-related morbidity before they consent," Dr. Maria Kyrgiou of Central Lancashire Teaching Hospitals in Preston, Great Britain, told HealthDay.

Effects of LEEP

However, the effects of these treatments on pregnancy and and future fertility are still not clear. But doctors and researchers have tried to assess the potential impact of having these procedures done by analyzing date from 27 previous studies.

Dr. Kyrgiou and her colleagues found that cold knife conization, which involves the excision of a cone-shaped piece of tissue, increased the risk of having preterm birth and delivering a low-birth-weight baby by by 2 ½ times and tripled the risks of having caesarian section, compared with women who did not have the procedure. LEEP increased the risk of premature delivery by 70 percent. It increased the risk of a low-birth-weight infant by as much as 80 percent. Plus, it more than tripled the risk of premature rupturing of cervical membranes.

Though the researchers also found that laser ablation also yielded similar results, but the finding were reported to be not statistically significant. The doctors also said that using a laser to remove abnormal tissue was the only method that did not increase complications in pregnancy.

Appropriate Study

Though the results of the study look promising, two women’s health experts warned about ‘drawing conclusions from a study that involved pooling of data from multiple retrospective studies’. One even warned about comparing obstetrical results among procedures used to treat different types of lesions or tissue abnormalities.

Dr. Annekathryn Goodman, associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School says that ""The appropriate study that would answer the question would be to compare LEEP and laser used for the same kind of lesion and the same size lesion done all at one institution." Goodman emphasized the need to tailor the treatment to the type of lesion, saying "small lesions only need small procedures, and larger lesions need big procedures". Goodman also added that if given the wrong treatment and the lesion is not completely removed, the woman is at an increased risk for developing cancer.

According to Dr. Goodman only women with high-grade precancerous lesions should be treated with LEEP. Dr. Carolyn D. Runowicz, director of the Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center agrees that women with portentous lesions should get LEEP treatment to prevent invasive cervical cancer, adding that "women should also get a second opinion before undergoing a procedure".

Regular screenings and vaccines

However, for Dr. Runowicz, it is more important that patients get regular screenings to prevent getting these lesions in the first place.

Apart from regular screenings, women are also fortunate to have additional ammo in their fight against lesions caused by the human papillomavirus (HPV). In 2006, the U.S. Food and Drug Administration approved Gardasil, a vaccine to prevent cervical cancer. Dr. Joan L. Walker, chief of gynecologic oncology at the University of Oklahoma Health Sciences Center says that "HPV vaccine is the answer".


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