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Re: PREGNANCY: Pregnancy Complications
From: Robin (anonymous@obgyn.net)
Thu, 22 May 2008 17:44:41 -0500 (CDT)
Thank you very, very much!
At Sat, 17 May 2008, anonymous@obgyn.net wrote:
>
>It should be fairly easy to do an on line search. Yes, there have been
>some studies. Here are some articles:
>http://www.greenjournal.org/cgi/reprint/109/2/309.pdf
>
>http://cervicalcancer.about.com/od/cervicaldysplasia/a/leep_pregnancy.htm
>http://www.emedicine.com/med/TOPIC3245.HTM
>Cervical polyps are not the same...they are not part of the skin, but
>rather a separate slice of tissue that is just clipped away. A LEEP
>actually removes cells that are normally there.
><<
>How a future pregnancy will be affected by a LEEP depends on how much
>cervical tissue has been removed by the LEEP and whether LEEP or other
>cervical surgery has been previously performed. Keep in mind that these
>complications affect only one to two percent of women who have a LEEP,
>but there is a slightly elevated risk of pre-term labor. Most women do
>go on to have healthy pregnancies that go full term. >>
>
>http://www.emedicine.com/med/TOPIC3245.HTM
>
>Cervical trauma
>
><<<The most common etiologies for cervical injury are elective abortion,
>surgeries to treat cervical dysplasia, and injury occurring at delivery.
>A single uncomplicated elective abortion at less than 10 weeks'
>gestation does not increase the risk of midtrimester loss or preterm
>birth unless the cervix has been forcibly dilated to more than 10 mm at
>the time of the abortion. However, patients with a history of multiple
>first-trimester elective terminations or one or more second-trimester
>elective abortions may be at increased risk for preterm delivery.
>Cervical dilatation with laminaria or cervical ripening agents, such as
>misoprostol, appears to be less traumatizing to the cervix than
>mechanical dilation.
>
>Cervical dysplasia should be treated appropriately whenever diagnosed.
>However the incidence of preterm birth and cervical incompetence may be
>increased 200-300% after preconceptual surgical treatment (eg, cold
>knife cone, cryoconization, laser cone, LEEP) of cervical
>intraepithelial neoplasia (CIN). The risk of subsequent preterm
>delivery may be proportional to the amount of cervical tissue removed
>during surgery. Surprisingly, the ease of performing LEEP for
>relatively minor abnormalities may have paradoxically led to more
>cervical injury than was observed with the relatively more invasive cone
>biopsy.
>
>Obstetric trauma may be underestimated as a risk for midtrimester loss
>or preterm birth. While women may relate a history of cervical
>laceration, often they are unaware of the injury and the obstetric
>records of the previous delivery may be misleading as to the extent of
>the cervical injury. Therefore, the obstetrician should rely on visual
>inspection of the cervix for assessment of injury and risk. Defects
>that involve more than 50% of the cervical length may indicate a higher
>risk for midtrimester loss. The accuracy of transvaginal ultrasonic
>measurements to determine risk of cervical incompetence, specifically in
>the presence of a history of cervical trauma, has yet to be
>determined.>>
>
>--
>Pat Sonnenstuhl, CNM, CPPI, CHt
>Peace on Earth Begins with Birth
>Birth Counseling and Fertility Therapy
>http://home.comcast.net/~prebirthhealth/birthcounseling.htm
>Hypnosis for Healing
>http://home.comcast.net/~prebirthhealth/hypnosisforhealing.htm
>Peaceful Birthing
>http://www.peacefulbirthing.org
>
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