Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

2 results

  • Chapter 3 - Cervical Abnormalities in Pregnancy

  • Edited by Swati Jha, Sheffield Teaching Hospital NHS Foundation Trust, Priya Madhuvrata, Sheffield Teaching Hospital NHS Foundation Trust
  • Book:
    Gynaecology for the Obstetrician
    Published online:
    14 July 2023
    Print publication:
    03 August 2023, pp 23-30

  • Summary

    Conservative management of high-grade pre-invasive disease of the cervix (CIN2–3 ) during pregnancy is acceptable. However, persistent high-risk HPV infection is a major risk factor for CIN2+ persistence. Close follow-up with HPV testing, and antenatal and post-partum colposcopic evaluation including directed biopsies are necessary. However, women who have undergone excisional treatment for CIN2 and above have an increased risk of preterm delivery and preterm rupture of membranes (PROM). Smoking is an important impact factor that could change the vaginal environment influencing the viral load. Treated patients should be informed about increased risk of preterm births and clinicians should offer the most appropriate treatment to optimise the chances of a healthy pregnancy without compromising women’s treatment options. In women diagnosed with invasive cervical cancer in pregnancy, the option of neoadjuvant chemotherapy (NACT) as a means of reaching fetal maturity versus termination followed by definitive management should be offered to the patient.

  • 10 - Impact of LLETZ on subsequent pregnancies

  • from SECTION 3 - Gynaecological Cancers and Precancer
  • Edited by Sean Kehoe, Eric Jauniaux, Pierre Martin-Hirsch, Philip Savage
  • Book:
    Cancer and Reproductive Health
    Published online:
    05 October 2014
    Print publication:
    01 November 2008, pp 115-124

  • Summary

    Large loop excision of the transformation zone (LLETZ) was introduced in the late 1980s and has now become the most popular method of treatment for cervical intraepithelial neoplasia (CIN). It is well known that women with CIN have demographic, behavioural, and sexual characteristics that put them at increased risk of pregnancy-related morbidity. Outcomes related to fertility are reported in two studies after LLETZ, one after laser conisation and after laser ablation, and one after cold knife conisation (CKC). The differences in the seriousness of adverse effects noted between CKC and LLETZ might be related to variations in the amount of tissue removed. Clinicians should counsel women appropriately before excisional treatment regarding the increased risk of preterm birth in a future pregnancy. Women requiring treatment with either CKC, laser conisation or a relatively large loop excision should be warned that they may warrant closer antenatal care in a subsequent pregnancy.