Value and feasibility of LLETZ procedures for pregnant women with suspected high-grade squamous intraepithelial lesions and microinvasive cervical cancer

International Journal of Gynecology & Obstetrics, 06/01/2012

LLETZ during pregnancy can be performed if invasive cancer cannot be excluded by colposcopy, cytology, or biopsy. The procedure has a diagnostic intention but can also be a curative therapy in pregnancy, with low intraoperative, postoperative, and peripartum complication rates.

Methods

  • A retrospective study included 27 patients who underwent LLETZ during pregnancy for suspected high–grade squamous intraepithelial lesions (HSIL) where microinvasion could not be excluded.
  • The study investigated intraoperative and postoperative complications, and compared preoperative and postoperative results.
  • Questionnaires were used to obtain information about peripartum and postpartum data.

Results

  • Three (11.1%) women had invasive or microinvasive cancer, 22 (81.5%) had cervical intraepithelial neoplasia (CIN) 3, and 1 (3.7%) had CIN 2.
  • Twenty–four were positive for high–risk human papillomavirus.
  • All cervical cancers were classified as HSIL or CIN 3 before LLETZ. There were positive resection margins in 15 (55.6%) cases.
  • No intraoperative complications occurred. One (3.7%) patient had a postoperative missed abortion.
  • Major complications such as premature labor or cervical incompetence without influence on delivery occurred after LLETZ in 4 (14.8%) patients.

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