A loop electrosurgical excision procedure (LEEP) is a method of removing cervical tissue using a wire loop charged with an electrical current. This is often necessary when treating cervical dysplasia, in which precancerous cells are found in the cervix. Though this treatment can stop some women from developing cervical cancer, it also can threaten future pregnancies, because the cervix may became too tight to dilate during the baby's birth. Some women also complain of an incompetent cervix, in which the cervix has trouble staying closed during pregnancy, sometimes resulting in pre-term labor. For these reasons, women experiencing pregnancy after a LEEP procedure are usually considered to have a high-risk pregnancy.
One of the most common risks of pregnancy after a LEEP procedure is cervical stenosis, in which the cervix becomes narrow and tight. While this is not problematic during much of the pregnancy, it can be during childbirth. The cervix in such a case 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 Caesarean section, which does not require dilation of the cervix.
The other typical worry 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 the pregnancy. When this occurs during early pregnancy, a miscarriage may occur because the fetus is often too young to live outside the womb. Later in pregnancy, the main worry is pre-term labor, which can result in health complications or even death for the baby, depending on his gestational age at the time of birth. Doctors can offer the woman a cervical cerclage if they suspect an incompetent cervix, which may allow the cervix to stay closed until the pregnancy is full-term.
While the risks of pregnancy after a LEEP procedure tend to be serious, they can often be avoided if women talk to their doctors about the potential issues. The risks usually depend on how much of the cervix was removed and the number of LEEP procedures the woman has had. In many cases, pregnancy after a LEEP procedure can go smoothly as long as extra precautions are taken, which is why women are advised to tell their doctor about the past surgery so they can proceed with all necessary information.