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Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP)

BACKGROUND/PURPOSE: This study aims to investigate whether women with cervical dysplasia after LEEP have an increased risk of pregnancy/childbirth complications or recurrence of dysplasia in an upcoming pregnancy. METHODS: Data from 240 women after LEEP were analysed retrospectively. The reference g...

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Autores principales: Lieb, Jule Alena, Mondal, Anne, Lieb, Lenard, Fehm, Tanja Natascha, Hampl, Monika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10023759/
https://www.ncbi.nlm.nih.gov/pubmed/36068362
http://dx.doi.org/10.1007/s00404-022-06760-5
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author Lieb, Jule Alena
Mondal, Anne
Lieb, Lenard
Fehm, Tanja Natascha
Hampl, Monika
author_facet Lieb, Jule Alena
Mondal, Anne
Lieb, Lenard
Fehm, Tanja Natascha
Hampl, Monika
author_sort Lieb, Jule Alena
collection PubMed
description BACKGROUND/PURPOSE: This study aims to investigate whether women with cervical dysplasia after LEEP have an increased risk of pregnancy/childbirth complications or recurrence of dysplasia in an upcoming pregnancy. METHODS: Data from 240 women after LEEP were analysed retrospectively. The reference group consisted of 956 singleton births. Fisher’s and Wilcoxon rank tests were used to detect differences between groups. Using logistic regressions, we analysed the effect of surgery-specific aspects of LEEP on pregnancy/childbirth complications and the frequency of CIN recurrences. RESULTS: We found that tissue-preserving LEEP did not lead to premature birth or miscarriage and did not increase the likelihood of CIN recurrence. We did not observe differences regarding preterm birth [< 37 (p < 0.28) < 34 (p < 0.31), < 32 weeks of gestation (p < 0.11)] or birth weight (< 2500 g (p < 0.54), < 2000 g (p < 0.77) between groups. However, women after LEEP exhibit a higher risk of premature rupture of membranes (PROM) at term (p < 0.009) and vaginal infections (p < 0.06). Neither volume nor depth of the removed tissue nor an additional endocervical resection seems to influence the likelihood of premature birth or early miscarriage. Performing an endocervical resection protects against CIN recurrence (OR 0.0881, p < 0.003). CONCLUSIONS: After tissue-preserving LEEP, there is an increased risk of vaginal infections and PROM at term in consecutive pregnancy. LEEP does not affect prematurity or miscarriage. The removal of additional endocervical tissue appears to be a protective factor against recurrence of CIN.
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spelling pubmed-100237592023-03-19 Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP) Lieb, Jule Alena Mondal, Anne Lieb, Lenard Fehm, Tanja Natascha Hampl, Monika Arch Gynecol Obstet Gynecologic Oncology BACKGROUND/PURPOSE: This study aims to investigate whether women with cervical dysplasia after LEEP have an increased risk of pregnancy/childbirth complications or recurrence of dysplasia in an upcoming pregnancy. METHODS: Data from 240 women after LEEP were analysed retrospectively. The reference group consisted of 956 singleton births. Fisher’s and Wilcoxon rank tests were used to detect differences between groups. Using logistic regressions, we analysed the effect of surgery-specific aspects of LEEP on pregnancy/childbirth complications and the frequency of CIN recurrences. RESULTS: We found that tissue-preserving LEEP did not lead to premature birth or miscarriage and did not increase the likelihood of CIN recurrence. We did not observe differences regarding preterm birth [< 37 (p < 0.28) < 34 (p < 0.31), < 32 weeks of gestation (p < 0.11)] or birth weight (< 2500 g (p < 0.54), < 2000 g (p < 0.77) between groups. However, women after LEEP exhibit a higher risk of premature rupture of membranes (PROM) at term (p < 0.009) and vaginal infections (p < 0.06). Neither volume nor depth of the removed tissue nor an additional endocervical resection seems to influence the likelihood of premature birth or early miscarriage. Performing an endocervical resection protects against CIN recurrence (OR 0.0881, p < 0.003). CONCLUSIONS: After tissue-preserving LEEP, there is an increased risk of vaginal infections and PROM at term in consecutive pregnancy. LEEP does not affect prematurity or miscarriage. The removal of additional endocervical tissue appears to be a protective factor against recurrence of CIN. Springer Berlin Heidelberg 2022-09-07 2023 /pmc/articles/PMC10023759/ /pubmed/36068362 http://dx.doi.org/10.1007/s00404-022-06760-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Gynecologic Oncology
Lieb, Jule Alena
Mondal, Anne
Lieb, Lenard
Fehm, Tanja Natascha
Hampl, Monika
Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP)
title Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP)
title_full Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP)
title_fullStr Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP)
title_full_unstemmed Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP)
title_short Pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (LEEP)
title_sort pregnancy outcome and risk of recurrence after tissue-preserving loop electrosurgical excision procedure (leep)
topic Gynecologic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10023759/
https://www.ncbi.nlm.nih.gov/pubmed/36068362
http://dx.doi.org/10.1007/s00404-022-06760-5
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