Pre-Cancerous Treatment Linked to Pregnancy Problems
Reported February 10, 2006
(Ivanhoe Newswire) — Women who undergo treatments aimed at removing abnormal cells that could lead to cervical cancer are at an increased risk for pregnancy complications, report British and Greek researchers.
Investigators looked at research conducted on four different procedures used to remove pre-cancerous cells — cold knife conisation, laser ablation, laser conisation, and large-loop excision of the transformation zone (LLETZ). Conisation refers to excision of a cone-shaped wedge of the cervix that includes the transformation zone — the part of the cervix where one type of cell transforms into another type of cell and is the area where abnormal cells usually develop.
Researchers linked cold knife conisation to a higher incidence of pre-term delivery, low-birth weight babies and the need for a cesarean section. LLETZ was associated with pre-term delivery, low-birth weight babies and premature rupture of the woman’s membranes during labor. Laser conisation was linked to adverse effects as well but to a lesser extent than other treatments.
Laser ablation didn’t appear to raise the risks for pregnancy complications but was less popular because it destroys the epithelium of the transformation zone and thus requires a prior biopsy to test the cells for cancer.
The authors note the findings on the LLETZ procedure are particularly worrisome as this is now the most common treatment for abnormal cervical cells.
Given the link between these procedures and pregnancy complications, they also believe doctors may simply want to monitor younger women with mild abnormalities rather than offer treatment right away. Researchers suggest it may also be advisable to forego cervical screening until after age 25.
SOURCE: The Lancet, 2005;367:489-499
