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Why You Should Wait at Least a Year to Get Pregnant After This Surgery

Photograph by Twenty20

If you've have had surgery in order to treat precancerous abnormalities on your cervix, then you may have something else to worry about now: having a premature or low-birth weight baby.

A study published in medical journal PLOS ONE has suggested that women who have had surgery to remove precancerous cells from their cervix are more likely to have premature or low-birth weight babies than those who have not had the procedure.

In order to gather the data, researchers examined information on pregnancy outcomes of 4,307 women who did not have a cervical procedure and compared that to 322 women who have had surgery to remove precancerous tissue as well as another 847 women who have had cervical biopsies in order to investigate abnormalities.

The results were clear: If a woman underwent surgery that cut out at least one centimeter of tissue, then she was more than twice as likely to have a preterm birth or an underweight baby. In fact, for women who gave birth within one year of cervical surgery, the study showed that their odds of these complications actually more than tripled.

The study also stated that, compared to women who didn't have surgery, those who had precancerous cells were more likely to be smokers and overweight or obese. They were also more likely to be first-time mothers.

"Women who have already had the surgery to remove precancerous lesions may want to wait a while to get pregnant," said study co-author Allison Naleway, of the Kaiser Permanente Center for Health Research in Portland, Oregon, "as we found the risk of pre-term birth increased even more if women gave birth within a year of their surgery."

During the study, researchers focused on women who had a common condition known as cervical dysplasia (which is abnormal tissue growth that is typically caused by HPV). While milder cases of this condition may actually go away on their own, doctors often surgically remove abnormal tissue in cases that are severe. This is suggested to help prevent the dysplasia from progressing to cervical cancer.

Researchers examined different types of common surgical methods for removing or destroying the precancerous tissue and found that it wasn't just the surgery that could affect pregnancy outcomes, but also the method of cell and tissue removal used. They looked at three common methods.

Of women who had ablation procedures using a thin wire loop to burn tissue, about five percent of them had preemies (compared to about 10 percent of women who had less than 1.6 centimeters of tissue excised with scalpels). Meanwhile, for women who had 1.6 centimeters of tissue or more cut out, 28 percent of them had preterm babies. Only seven percent of the women who had no surgery at all had preterm babies. For women who had cervical biopsies, about eight percent of them had preterm babies.

Furthermore, women who had an excision procedure that cut out at least one centimeter of tissue were 2.2 times more likely to have low-weight babies than those women who had no cervical surgery or who had only biopsies. Miscarriages and stillbirths were also more likely among women who had ablations, with 25 percent of those women experiencing pregnancy loss. Comparatively, only 19 percent of women who had cell or tissue removal procedures and 18 percent of women who didn't have cervical surgery or biopsy at all had the same risk.

Dr. Christina Chu, a gynecologic oncology researcher at Fox Chase Cancer Center in Philadelphia who wasn’t involved in the study but spoke with reporters at Reuters, suggests that the results may indicate that the treatment of cervical dysplasia, rather than the condition itself, is a relevant factor in increasing the risk of pregnancy complications.

Doctors suggest that to protect yourself from HPV, girls and young women should get the HPV vaccine.

Meanwhile, for women who have been treated for this condition, waiting to have a baby makes the most sense since, as Chu said further, "It does appear that the risks may be less for women who deliver more than one year after excision."

If you're someone who has had this procedure, consider it best to delay pregnancy in order to allow the cervix to fully heal.

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