Womb cell op 'raises birth risk' The most common operation to remove abnormal cervical cells raises the risk of giving birth early, experts say. A study of 5,000 Australian women found when a heated wire, loop diathermy, was used the risk rose substantially.
Young women should not automatically have diathermy, the British Journal of
Obstetrics and Gynaecology (BJOG) says.
UK experts said abandoning the treatment could mean up to 1,500 fewer premature
births a year - and they said doctors should consider alternatives.
Last year, more than 3.3 million women in the UK underwent screening, and just
over 1% of these had clear changes in the cells lining the cervix.
Women need to know about the risks involved and discuss alternative
treatments with their gynaecologist, before going ahead with a procedure that
increases the risk of pre-term birth
Phil Steer
BJOG
Women with severe changes in these cells are at higher risk of going on to
develop cervical cancer at some point, and are often referred to hospital to
have them removed.
Increased risk
There are three main ways of doing this, two of which - cone biopsy and loop
diathermy - can remove relatively large amounts of tissue from the cervix. Cone
biopsy is now used only rarely in the UK.
The third - called laser ablation - destroys just the abnormal surface cells.
While other studies have already made a link between loop diathermy and
premature birth, the Australian research, from Melbourne University and Royal
Women's Hospital in Australia, is the largest yet.
It found that having had abnormal cells, regardless of the method of removal,
increased the risk of having a premature baby, but having either loop diathermy
or cone biopsy raised that risk even further.
Only the laser ablation technique - in the UK more commonly used on women with
very mild cell changes - did not increase the chance of a premature baby.
Babies born prematurely - before 37 weeks pregnancy - are at increased risk of
a variety of health problems.
Practical problems
The researchers said that doctors should consider using alternatives to loop
diathermy in women of childbearing age, and that women should be made fully
aware of the risks before undergoing the procedure.
Phil Steer, editor of the BJOG said: "Women need to know about the risks
involved and discuss alternative treatments with their gynaecologist, before
going ahead with a procedure that increases the risk of pre-term birth."
Dr Margaret Cruickshank, a senior lecturer in obstetrics and gynaecology at
Aberdeen University, said that the vast majority of UK women with abnormal
cells currently received diathermy rather than ablation.
She said there would be huge practical difficulties and expense involved in
hospitals abandoning it.
"The key thing appears to be the volume of tissue removed, and we need to find
out in more detail the relationship between this and the risk of preterm
birth."
She said that the main advantage of diathermy was that it produced a sample of
tissue which could be removed and analysed in the laboratory to make sure a
cancer had not been missed, whereas ablation destroyed the tissue.
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/6227555.stm
Published: 2007/01/03 11:57:27 GMT
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