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Safety of LEEP surgery and labor

February 16, 2018

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    The progress of labor depends on the cervix dilating and the baby moving into the pelvis.

  • Excision treatments of the cervix with an electrified loop are called "LEEP procedures. They remove a cone shaped piece of tissue and are used for the diagnosis an treatment of advanced cervical disease.

  • It is possible that LEEP procedures can affect getting pregnant, birthing preterm, and the conduct of labor.

  • You need to find out from your obstetrician whether your labor would be affected by having a LEEP

  • Most women will not have problems birthing full term even if they have had a LEEP procedure.

 A lot of research has looked into the risk for preterm labor in women who have had a LEEP procedure. But a research group from Washington University in St Louis, in a study presented at the Society for Maternal-Fetal Medicine's 32nd meeting, decided to look at how the cervix functions during labor itself, asking question if having a LEEP put a woman at risk for c-sections, prematurity (delivering before 34 weeks was defined as prematurity), or whether they had pregnancy losses before 20 weeks. They looked at women who had LEEPs, just pap smears, or pap smears and biopsies for abnormal pap smears. And it did not. This study looked at women over a 7 year period of time, so it was a more intense study than other studies, and they looked at a lot of detail about these women. In fact even very large specimens vs. smaller amounts of tissue removed did not  affect the ability to have a full term vaginal birth, as in the LEEP group there was no increased risk for premature birth. Their point was that women with LEEP would not need any additional testing just based on the fact that they had a prior surgery of their cervix. Since this study the 2013 trend has, however, been to look more closely at the length and health of the cervix of all pregnant women, not just those who have had LEEP procedures, to see if we can identify a subset of women who might need progesterone treatment to help them go to full term.

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