Study shows that loop excision may be linked to premature birth

GPs should consider using alternatives to loop excision for the treatment of precancerous changes in the cervix, according to Australian research.

A study of 5,548 Australian women at the Melbourne University and Royal Women’s Hospital found that the risk of having a premature baby was 1.7 times greater when loop excision was used. However, women who had laser ablation were not at increased risk of premature birth.

The study says that laser ablation can destroy precancerous cells without causing any damage to the cervix, which can occur during loop excision leading to an increased risk of premature birth.

Professor Phillip Steer, editor of the British Journal of Obstetrics and Gynaecology, said: ‘Women considering having a baby should ask their doctor about the alternative treatments.

‘Premature birth can cause long-term problems for the baby and anything which increases this risk should be avoided.’

It has been shown that a laser ablation has no adverse effect on fertility, whereas loop excision carries an increased risk of fertility problems, he said.

However, laser ablation is a much more expensive treatment than loop excision. Loop excision is the most common and cheap treatment to remove cancerous cervical cells, he added.

Bradford GP and specialist in gynaecology Dr Anne Connolly, said: ‘Loop excision is the recommended treatment and should be used to reduce the risks of early cervical disease.’

The evidence base supports the use of loop excision and there needs to be more evidence to show that it is dangerous.

Until the Royal College of Obstetricians and Gynaecologists says otherwise, loop excision should continue to be used, she said.

sanjay.tanday@haymarket.com

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