What is the Obstetric Outcome with a Large Loop Excision of the Transformation Zone (LLETZ) for Cervical Intraepithelial Neoplasia?

Objective: To find out the association of large loop excision of the transformation zone (LLETZ) at or less than 36 weeks of gestation, extreme preterm delivery at or less than 28 weeks gestation and perinatal mortality with premature birth. Design: Data was collected from euroking, ‘joe’ and e-searcher systems of 407 retrospective cases. The data were analysed pre and post cervical histology between 20-43 weeks of pregnancy to identify live births. Setting: East Sussex Healthcare Trust Population: The selected population were women who became pregnant after LLETZ treatment at the East Sussex hospital. Their case notes and histology reports were taken into account. The women who were not included in this study were those in age group greater than 42 years, previous premature labour or twin pregnancies. Result: Total number of deliveries in East Sussex hospital in a year were 4349 and the deliveries at term gestation (37 +) were 4057. The total number of all preterm deliveries were 268 (6.16 %), 34 to 36+6 weeks were 198 (4.55 %) and less than 34 weeks were 70 (1.6 %). In 24 cases gestation was unknown. The total data collected were of 407 LLETZ treatment cases. The number of premature deliveries were 45 (11 %) as against background risk of 6.16%. Those who had term pregnancy prior to LLETZ were 15 out of these 45 cases, and the remaining had their first pregnancy after having LLETZ. Conclusion: LLETZ increases the chances of premature births.