LEEP is a procedure to remove cervical tissue, but it can cause cervical stenosis and an incompetent cervix, making pregnancy risky. Doctors can take precautions during delivery or offer cervical cerclage to prevent premature labor. Women should inform their doctor about the procedure.
A loop electrosurgical excision procedure (LEEP) is a method of removing cervical tissue using a loop of wire charged with an electric current. This is often necessary when treating cervical dysplasia, where precancerous cells are found in the cervix. While this treatment can keep some women from developing cervical cancer, it can also threaten future pregnancies, because the cervix may become too narrow to dilate during delivery. Some women also complain of an incompetent cervix, where the cervix has trouble staying closed during pregnancy, sometimes resulting in preterm labor. For these reasons, women who have become pregnant after a LEEP procedure are generally considered to be at high risk.
One of the most common pregnancy risks after a LEEP procedure is cervical stenosis, in which the cervix becomes tight and tense. While this isn’t a problem during much of pregnancy, it can be during delivery. In this case, the cervix cannot dilate easily, leading to a particularly long labor and delivery. When nurses and doctors are aware of the LEEP procedure, they can often focus on dilating the cervix more gently than usual until it is as wide as it needs to be. Another option is a cesarean section, which doesn’t require dilation of the cervix.
The other typical concern of women who experience pregnancy after a LEEP procedure is that their cervix is too weak to carry the baby to term. An incompetent cervix is likely to open prematurely during pregnancy. When this occurs in early pregnancy, a miscarriage can occur because the fetus is often too young to live outside the uterus. Later in pregnancy, the primary concern is preterm labor, which can lead to health complications or even death of the baby, depending on its gestational age at the time of birth. Doctors may offer a woman cervical cerclage if they suspect an incompetent cervix, which may allow the cervix to remain closed until the pregnancy is finished.
While the risks of becoming pregnant after a LEEP procedure tend to be serious, they can often be avoided if women talk to their doctors about potential problems. The risks usually depend on how much of the cervix has been removed and the number of LEEP procedures the woman has had. In many cases, pregnancy after a LEEP procedure can be fine as long as extra precautions are taken, which is why women are advised to tell their doctor about the previous surgery so they can proceed with all the necessary information.
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