Related Experiment Video
Updated: Jun 20, 2026
Improved Hysteroscopic Resection of Endometrial Polyps Using 6-Fr Micro-Scissors and Forceps
Published on: August 2, 2024
Loop electrosurgical excision procedure and the risk for preterm birth.
Maija Jakobsson1, Mika Gissler, Jorma Paavonen
1From the Department of Obstetrics and Gynaecology, University Hospital, Helsinki, Finland; and THL National Institute for Health and Welfare, Helsinki, Finland; and Nordic School of Public Health, Gothenburg, Sweden.
Loop electrosurgical excision procedure (LEEP) conization significantly increases preterm birth risk, particularly for women without prior preterm births. Larger or repeat LEEP procedures further elevate this risk, highlighting the need for careful consideration of this cervical treatment.
Area of Science:
- Gynecology
- Obstetrics
- Reproductive Health
Background:
- Cervical procedures like Loop Electrosurgical Excision Procedure (LEEP) conization are common for treating cervical dysplasia.
- The potential impact of LEEP conization on subsequent pregnancy outcomes, specifically preterm birth, requires thorough investigation.
Purpose of the Study:
- To determine if LEEP conization is associated with an increased risk of preterm birth.
- To evaluate the influence of LEEP conization cone size and repeat procedures on preterm birth rates.
Main Methods:
- Retrospective cohort study in Southern Finland (1997-2006) involving 624 women who underwent LEEP conization.
- Comparison of preterm birth rates post-LEEP with background rates and internal controls (pre-LEEP deliveries).
- Subgroup analysis focused on cone size and repeat procedures.
Main Results:
- LEEP conization nearly tripled the risk of preterm delivery (RR 2.61), with repeat treatments increasing risk over fivefold (RR 5.15).
- Large or repeat cones doubled the risk compared to smaller ones (RR 2.45).
- Women without prior preterm birth experienced a significantly higher risk post-LEEP (RR 3.38).
Conclusions:
- LEEP conization predisposes patients to preterm birth.
- The risk is particularly elevated in women without a history of preterm birth.
- Repeat LEEP procedures are associated with the highest rates of preterm delivery.
