OBJECTIVE: To determine whether cervical length measurements in patients who have undergone a loop electrosurgical excision procedure (LEEP) is a predictor of spontaneous preterm delivery (PTD) at < 35 weeks. STUDY DESIGN: A retrospective chart review of 97 pregnant patients with a history of prior LEEP undergoing cervical length screening by transvaginal ultrasound (TVUS) was done. Of these, 87 were included in the study. All patients delivered at the St. Luke's Hospital and Health Network over a 5-year study period. Cervical length measurements in the LEEP group were included. Incidence of PTD in patients who have undergone prior LEEP was compared to patients delivered during the same period who had not undergone LEEP. RESULTS: Of 87 patients who had undergone LEEP, 3 (3.4%, 95% CI 1.1-9.6%) delivered at < 35 weeks. None of the 3 patients had cervical shortening on TVUS. The PTD rate was not statistically different in the LEEP and non-LEEP groups. A shortened cervix was noted in 4 of the 87 patients in the LEEP group (4.5%, 95% CI 1.8-11%) but none had a PTD. CONCLUSION: Cervical length screening in LEEP patients may not be a predictor of PTD.
OBJECTIVE: To determine whether cervical length measurements in patients who have undergone a loop electrosurgical excision procedure (LEEP) is a predictor of spontaneous preterm delivery (PTD) at < 35 weeks. STUDY DESIGN: A retrospective chart review of 97 pregnant patients with a history of prior LEEP undergoing cervical length screening by transvaginal ultrasound (TVUS) was done. Of these, 87 were included in the study. All patients delivered at the St. Luke's Hospital and Health Network over a 5-year study period. Cervical length measurements in the LEEP group were included. Incidence of PTD in patients who have undergone prior LEEP was compared to patients delivered during the same period who had not undergone LEEP. RESULTS: Of 87 patients who had undergone LEEP, 3 (3.4%, 95% CI 1.1-9.6%) delivered at < 35 weeks. None of the 3 patients had cervical shortening on TVUS. The PTD rate was not statistically different in the LEEP and non-LEEP groups. A shortened cervix was noted in 4 of the 87 patients in the LEEP group (4.5%, 95% CI 1.8-11%) but none had a PTD. CONCLUSION: Cervical length screening in LEEP patients may not be a predictor of PTD.
Authors: Maria Kyrgiou; Antonios Athanasiou; Maria Paraskevaidi; Anita Mitra; Ilkka Kalliala; Pierre Martin-Hirsch; Marc Arbyn; Phillip Bennett; Evangelos Paraskevaidis Journal: BMJ Date: 2016-07-28