LLETZ and cone biopsy are performed if you have abnormal cervical screening test results (changes in the cells covering the cervix).
During the investigation following your test result (called a colposcopy), a small sample of cells may be taken. The results may show CIN. CIN is cervical intraepithelial neoplasia. It is not cancer. There are 3 levels of CIN and they relate to how deep into the skin the abnormal cells have gone.
- CIN 1 – up to one third of the thickness of the lining covering the cervix has abnormal cells
- CIN 2 – between one third and two thirds of the skin covering the cervix has abnormal cells
- CIN 3 – the full thickness of the lining covering the cervix has abnormal cells
In the LLETZ procedure a thin wire loop heated by an electrical current is used to remove the abnormal tissue from the cervix. It is a quick procedure, usually done under a local anaesthetic. The tissue sample is sent to a laboratory for examination.
A cone biopsy is so called because a cone-shaped piece of tissue is surgically removed from the cervix. The cone biopsy is usually done under a general anaesthetic and involves a day or overnight stay in hospital. Results are usually available in a week.
The risk of premature birth
Women who had have a cone biopsy or a LLETZ procedure, or any other procedure that involves the removal of cells from the cervix before pregnancy, are at higher risk of having a late miscarriage or premature birth (before 37 weeks).
The level of risk depends on the extent of the procedure that was carried out. Evidence shows that in cases where the excision is more than 10mm, or if more than one procedure has been carried out, then the risk is increased.
It is important to let the midwife know at your first booking appointment if you have had any type of procedure performed on your cervix.
More research is needed to assess the impact of these cervical procedures on pregnancy and at the moment there are no national guidelines on care, so different NHS trusts may offer different care.
Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis (OC), is a liver disorder that can develop during pregnancy.
Pre-eclampsia is a serious condition that only occurs during pregnancy, typically after 20 weeks. It is a combination of hypertension (high blood pressure) and proteinuria (protein in your urine).
Intrauterine infection, also known as chorioamnionitis, is infection within the womb.
Intrauterine growth restriction (IUGR), also known as fetal growth restriction (FGR) is a condition in which a baby's growth slows or stops during pregnancy.
If you have type 1 or type 2 diabetes, you will be used to managing it, but during pregnancy changes to your body and hormones mean that your previous treatment and self-care might have to change.
The way your life is lived can have an effect on your risk of premature birth.
Antiphospholipid syndrome (APS) is an autoimmune disorder in which the body’s immune system makes antibodies that attack and damage its own tissues or cells.
Some women have a congenital uterine abnormality, which is a womb/uterus that formed in an unusual way before birth.
When the cervix shortens and opens in the second trimester (16 to 24 weeks) or early in the third trimester without any other symptoms of labour it may be referred to as cervical incompetence or cervical insufficiency.
If your waters break early, seek medical advice straight away as you could be at risk of premature labour.
The placenta is your baby’s support system in the womb. If your placenta doesn’t work properly, your baby is at risk of health problems. Placental abruption is when your placenta comes away from the wall of your womb.
The placenta is your baby’s support system in the womb. If the placenta doesn’t work properly, your baby is at risk of health problems.
NHS Choices (accessed Nov 2016, Next review due: 15/12/2016) Colposcopy - Treatment http://www.nhs.uk/conditions/colposcopy/Pages/Treatment.aspx
RCOG (2016) Reproductive Outcomes after Local Treatment for Preinvasive Cervical Disease, Royal College of Obstetricians and Gynaecologists, London https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_21.pdf
Cancer research UK (Accessed Nov 2016. Updated: 2 June 2014, No review date given) Pregnancy and abnormal cervical cells. http://www.cancerresearchuk.org/about-cancer/type/cervical-cancer/smears...Hide details
ℹLast reviewed on December 14th, 2017. Next review date December 17th, 2020.