Since its introduction in1989, large loop excision of transformation zone (LLETZ) has been the most popular method used for the treatment of cervical intra-epithelial neoplasia (CIN). It has advantages like being performed in short duration, outpatient procedure, low cost, good compliance, simplicity and easier learning method.
There is a very good evidence to suggest that LLETZ has low morbidity and at the same time is successful at eradicating intraepithelial lesions and preventing invasive cervical cancer. But the data available with regard to future pregnancy outcomes are very conflicting.
Some studies have shown poor obstetric outcome after LLETZ, which involved preterm delivery, PPROM and low birth-weight. Whereas, most studies show that LLETZ has no adverse effects on pregnancy outcomes.
Therefore, the authors performed this retrospective study in a district general hospital. 63 women who underwent LLETZ procedure and subsequently delivered were selected randomly. The labour ward statistics for the similar period was used as control. Our study concluded that the caesarean section rate in the study group was lesser than in general population. Preterm delivery rate was not significantly higher than the general population (10% vs 8%).
Although there were significant women who smoked in the study group, the incidence of low birth-weight at term was still less (3% vs 4%).
It was obvious from our study that LLETZ does not appear to exert an independent adverse effect on subsequent pregnancy and neonatal outcomes. However, more studies should be performed before adopting LLETZ liberally for treating women with abnormal cervical smears.
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