Pregnancy Outcome Following Large Loop Excision of the Transformation Zone (LLETZ)

In recent years LLETZ in the management of CIN lesions has gained wide popularity. Treatment of CIN lesions with ablative methods such as cryotherapy, electro coagulation and laser vaporization is not known to be associated with adverse pregnancy outcome. However, high grade CIN lesions necessitate more effective methods such as cold knife cone biopsy and LLETZ. These methods are effective and cervical tissue is available for histopathological examination to rule out invasive carcinoma. Conventional cold knife cone excision of the cervix is known to be associated with incompetence of cervix leading to adverse pregnancy outcome such as mid-trimester abortions. However LLETZ of the cervix seems to be a simple and effective method of managing CIN lesions and has not been reported to result in adverse pregnancy outcome in subsequent pregnancies. Therefore, the present study was undertaken to ascertain 1) Whether LLETZ has any adverse outcome in subsequent pregnancies and labor 2) To elicit whether any adverse outcome is related to the cone and 3) To see whether outcome can be improved by the use of encerclage in pregnancy.