Birth experiences following cervical laser ablation for HPV

(16 Posts)
MissWa2a Thu 28-Aug-14 11:08:40

Hi there,

This is my first post, so apologies if I do something not quite standard. My question is this - has anyone had issues (or no problems!) giving birth 10 or so years after their cervix was lasered?

The context to this question is... In my mid 20's they found some abnormal cells and ultimately my cervix was lasered to get rid of them. Since then I have had no more dodgy smears.

I am now 35 and pregnant with my first baby, due 6th Nov. My question is prompted by the fact that the last time I had a coil put in (3yrs ago) it was very difficult for them to get it in - my local dr couldn't do it and when I went to the hospital it took the nurse/dr there a good 30 minute struggle and she said that my cervix wouldn't open, even though she'd be able to get the 'sound' in fine.

I'm planning (ha ha, yes, famous last words!) to give birth as 'naturally' as possible at the local midwife based unit. I'm concerned that my cervix is not going to open and I'm going to need an emergency C-section.

Would love to hear thoughts and experiences from those who have gone before me...
Many thanks

LovingSummer Thu 28-Aug-14 11:42:05

I had the same procedure done as you, and fell pregnant one year later.

It sounds like your cervix had some degree of stenosis where scar tissue fail to allow elasticity. The thing about pregnancy is the cervix changes to prepare for the baby, and there is no telling as far as I know whether this will alter a cervical stenosis or not.

To put your mind at rest I would discussed this with your midwife or your GP. Maybe they could refer you to a gynaecologist to check it out. However I would suggest they probably won't be able to tell at this early stage, and it's possible they will just want to document and keep a very close eye on you in labour.

My concern was that the cervix had not shut completely after the procedure, because they had cut so much tissue off! I bled a lot in the pregnancy, and the baby was born early too, but no one suggested the cervix was the reason for that.

I know some people need to have a stitch in place throughout their pregnancy, but usually this is due to cone biopsy which is a much deeper cut.

During my pregnancy I was due for a smear after having the procedure done. Obviously being pregnant they couldn't perform it, but they sent me to the clinic to look at the cervix. It's apparently it quite a mess, and they were unsure if it was due to the pregnancy changes in the cervix, so scheduled a second review three months after I have given birth.

When reviewed postpartum, the service like it has healed incredibly well, the snow came back negative, and the state of the cervix during the pregnancy (red, swollen, etc), was apparently just due to the fact that I was pregnant.

LovingSummer Thu 28-Aug-14 11:44:58

Oops sorry for typos! The 'service' is the cervix and the 'snow' is the smear!

Claxonia Thu 28-Aug-14 12:15:26

I had this procedure about 8 years before giving birth and didn't have any issues with my cervix. Despite babies being very low during the last weeks of pregnancy my cervix stayed fairly closed and then dilated normally during labour.

CaleyThistle Thu 28-Aug-14 20:57:13

I'm in similar circumstances to you. Had colposcopy 16 years ago and am pregnant at age 37 with my first. I'm booked for an ultrasound next week (18wks) to check the thickness of the scaring on my cervix with a view to determining what that might mean for my cervix during pregnancy / labour. Some studies suggest midwives can massage your cervix during labour to release the scar tissue. The main issue seems to be your won't dilate as expected, will be classed as 'not progressing' and wipped off for an EMCS. At least you are aware there may be an issue, and as suggested above, can ask you MW for further advice. (Be quick, as I was advertised they like to carry out your cervical ultrasound at around 20wks). Good luck. I'll try and update after my scan next week.

MissWa2a Fri 29-Aug-14 18:26:23

Thanks for your responses - I've got my 31wk apt with midwife in just over a week so will raise it with her then (along with a bunch of other questions).
Claxonia, your experience is very reassuring - I hope I'm so lucky.
Caley, I'd love to hear what you find out at your scan...and I'll let you know what response I get...

CaleyThistle Fri 05-Sep-14 16:52:02

UPDATE: So I had my cervix scanned at the same time as they did my foetal abnormality scan. All the sonographer said was that my cervix was closed and it was a good length. She offered an internal scan but said that wouldn't give her any more details than the ultrasound so I declined. I told her I'd expected that the thickness and extent of the scaring on my cervix would be assessed and she said that was not possible. They just looked to see if it was closed and length.
On a side note, baby's growth now corresponds to my dates, not to the midwife's dates and because they are different, baby might need additional growth monitoring. Grrr. I TOLD them I didn't dtd during the week I had food poisoning!

MissWa2a Fri 05-Sep-14 18:15:45

Thanks for the update CaleyThistle - sorry you didn't get as much info out of it as you expected. Good luck with the rest of your pregnancy.

squizita Fri 05-Sep-14 20:07:54

Caley Did you only have a colposcopy? I'm a bit shock that this is considered to cause scarring?
I am 39 weeks, pregnant with no issues after recurrent MC (not related to cervix) and have had many tests due to the mcs. At no point has my colposcopy ever been mentioned as an issue (bearing in mind I'm under a very major centre and they would check).
Basically no one has ever mentioned a colposcopy causing scarring to the extent it interferes with childbirth although I'm under the care of a clinic who would deal with this type of thing. It's just never been raised.
Neither did the gynie clinic ever warn me it would mean I couldn't give birth. I researched quite a lot.
Could you give some more details about where you got this info?

squizita Fri 05-Sep-14 20:47:52

...I'm referring to the procedure where they paint some iodine up there and take some photos? And sometimes take a "pin head" sample biopsy (not a loop biopsy - this one feels like a needle prick and hardly bleeds).

Have you any British websites about risks after colposcopy?

NotMyChashkaChai Fri 05-Sep-14 21:00:32

Had cold coagulation to remove abnormal cells following colposcopy. Exactly three weeks after the procedure (earliest we were allowed to dtd) got pregnant with dd. 9 months later had natural home birth!

squizita Fri 05-Sep-14 21:07:20

Even Dr Google seems to say there is a small risk in some women after procedures following colposcopy Phew.
Will mention to my mw next time I see her but feel a bit more reassured.

rightsaidfred Fri 05-Sep-14 22:30:17

I am 37 weeks pg with number 3 15 years after LETZ diathermy treatment for CIN111
I have had 2 caesareans and am about to have a third because of the scarring to my cervix resulting from the procedure. I did however know about this before I got pregnant the first time having had several previous attempts under GA to investigate the cervix...... to attempt to put a coil in (2 failed attempts under GA to insert a coil, 2 attempts under GA at Ultrasound guided hysteroscopy) so there was good evidence that my cervix had lost flexibility and was stuck fast. How I manage to get pg we will never know!
Having been through all this I was happy to accept a planned section....... however my consultant gave me a range of options eg having a trial of labour

Squizita you are right- the colposcopy itself shouldn't be an issue it is the treatments after it (LETZ or cone biopsy) that are the issue....... but because the treatments are done using 'colposcopy' to visualise the cervix and are usually booked in to a 'colposcopy' clinic the term is often used more generally by lay persons.....
Aren't you usually the first person to say about stepping away from Dr Google? :-)

Meglet Fri 05-Sep-14 22:40:27

I had cervical stenosis following 2 LLETZ treatments. My periods were agony and didn't even flow out properly following the procedures. I would have to go for a run and get gravity to um, slosh, the blood out. My gynae said we could consider artificially dilating it at some point.

It all got left there and we didn't give it another thought until I was 12 hours into a hefty labour with DC1, with just 1cm dilation and DS at risk. So I had an EMCS and we agreed I never had to try and give birth naturally again, even the midwife said it would be dangerous to attempt a natural birth. Had a planned CS with DC2.

Gynae later said I could have jumped on a trampoline when pregnant and the baby wouldn't have shifted. My periods were much better after pregnancy though, the slight dilation in labour allowed them to flow out again.

squizita Fri 05-Sep-14 23:04:38

Right Yup. Oops sorry! Bad day... saw this thread at 39 weeks having had some 'twinges' this afternoon and had a little freak out ... blush ... my colposcopy investigations were just investigations (with a delightfully 'nutty professor' at the helm of the camera "zo now we will place on ze iiiiooodinne") so probably why no one batted an eyelid since. smile

Glad we live in a day and age where we can have these things to prevent illness and they can also assist us in giving birth.

CaleyThistle Sat 06-Sep-14 16:26:01

Yes, I had the abnormal cells detected by my cervical smear 'burnt off' - really can't remember the technical medical name for the treatment but at all my subsequent gyne appointments, the Dr / nurse has always commented that they can see the scars and it's healed nicely so the scaring must be visible to the naked eye if you know what you are looking for.
As a complete side issue, I tested negative for HPV, and my abnormal cells were detected after my very first smear so I have a bit of an issue with the HPV vaccine being touted as solving the cervical cancer issue. Please continue to get your smears ladies, and encourage all your female friends and relatives to do the same.

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