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Value and feasibility of LLETZ procedures for pregnant women with suspected high‐grade squamous intraepithelial lesions and microinvasive cervical cancer
Author(s) -
Schaefer Kristina,
Peters Dorothee,
Aulmann Sebastian,
Sohn Christof,
Eichbaum Michael H.R.
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.02.019
Subject(s) - medicine , colposcopy , cervical intraepithelial neoplasia , cervical cancer , obstetrics , pregnancy , biopsy , retrospective cohort study , intraepithelial neoplasia , surgery , gynecology , cancer , radiology , biology , genetics , prostate
Objective To evaluate the efficacy, safety, and feasibility of large loop excision of the transformation zone (LLETZ) procedures during pregnancy. 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. Conclusion 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.