Safety of LEEP in Treating CIN 2–3 During Pregnancy

Abstract

Cervical intraepithelial neoplasia (CIN) 2–3, a premalignant lesion usually treated by Loop Electrosurgical Excision Procedure (LEEP) in nonpregnant women, is addressed differently in pregnant women. Data from 2006 to 2023 on 178 pregnant women with CIN 2–3 were provided by the Israeli Society of Colposcopy. Sixty-seven underwent LEEP within 15 weeks of gestation with only minor complications. Of the 57 continuing pregnancies, 53 (93%) delivered at term, 2 (3.5%) at 34–37 weeks, and 2 (3.5%) experienced missed abortions. One hundred eleven women were followed through pregnancy without LEEP. Of that group, 5 women were lost to follow-up. From 173 women on whom the authors have follow-up data, 9 (5.2%) were finally diagnosed with cervical cancer, 132 women (76.3%) remained CIN 2–3, and 32 women (18.5%) were CIN 1 or normal. Loop Electrosurgical Excision Procedure (LEEP) performed within the first 15 weeks of pregnancy in 67 women was safe. In 5.2% of pregnant women with CIN 2–3, the final diagnosis was invasive cancer.