Previous LLETZ & Cervical Length

[Loubell19]

Hello this is my 1st pregnant and I'm just looking for people's experiences. I had CIN 3 (full thickness) 6 years ago requiring LLETZ procedure. I was told at the time theres a potential link with premature labour. When I booked in with this pregnancy both my community midwife and the one at the hospital said I'd need to see the consultant for a cervical length measurement.

I'm now 16 weeks and hadn't heard anything about an appointment so I asked my midwife to find out why. She spoke to her managers and they said unless the lletz was done under general anaesthetic (as far as I'm aware that's very rare to need just for lletz) it wouldnt have been big enough to cause significant scarring (despite my histology confirming full thickness changes). And therefore I dont even get an appointment or cervical length done?! And said the main risk would be your cervix might not fully dilate during labour due to scarring but if that happens we will deal with it at the labour.

I then asked but what about the risk of a short cervix with late miscarriage and premature labour risk- she said there was no risk of late miscarriage (which contradicts what the major website like Tommy's says) and with premature labour saying the risk is related to scarring not length?!

Just feel a bit concerned that this seems to go against all the official information I've read and worry if it's just a way to reduce the number of face to face appointments due to coronavirus rather than it truly being related to no risk to me or my baby :( or whether others have had the same experience?

I had a LETZ procedure (not too sure on thickness as it was years ago and my notes had been destroyed ). I got referred to the Pre Term Birth Clinic and had two scans at around 16 weeks and 22 weeks to check the length of my cervix (all fine) before being discharged. If I were you I would want to play it safe and would push for a referral to a consultant or the pre term birth clinic at your hospital, especially as yours was so thick. Good luck!

Thanks @UnrulySalvia. I've been doing some more research and apparently increased risk is if more than 10mm is removed so I might just ring my gp to find that out tomorrow then take it from there. I really dont want to seem ungrateful of the maternity services but just cant help but feel I was fobbed off a bit :(. Doesnt help that a lot of the midwife appointments have been cancelled now due to covid. Such a stressful time to be pregnant!

Hi. I have experienced exactly what you are going through. I'm now 17 weeks. At my booking app I was told by the midwife that they wouldn't put me at high risk and look into things as I was not put to sleep for my lletz. I wasn't happy with this as like yourself had been told something different by another midwife a few weeks earlier. I spoke with the colposcopy dept at the hospital who said this is nonsense and the same procedure can be done whether you are asleep or not. I spoke with a senior midwife in the antenatal team who looked into my files with the consultant and arranged a cervical length scan at 14 weeks. This scan showed my cervix was already under the recommended length and I was booked in for a cervical cerclage the next week. Whilst at the hospital for this procedure the consultant showed me my notes and it turns out I had 20mm removed when I had my lletz so well over the 10mm that they class as risky. My procedure has gone well so far and I am also on progesterone pessaries.

I would suggest you contact the dept who did your lletz and see if you can get information and then push to have a cervical length scan done. Xx

I'm currently 33 weeks, I had LLETZ in 2016 and they removed 10mm × 19mm x 21mm, 10 being from the length.

I didn't get referred for cervical length checks at first because of a mistake by my original midwife but lucky it was picked up about 13 weeks when I was concerned and asked another midwife in my local hospital who was able to bring up my records from 2016 and found the amount that had been removed.

I started getting checks every 2 weeks from 14 weeks to 24 weeks and despite having 10mm removed my cervix was still showing long enough and stayed around 40mm long! Mine is open a bit but they said that isnt a worry and its just about the length under the new guidelines.

Maybe its worth calling your hospital midwives if you are worried, hopefully they can help you as quickly as they got my scans sorted!

I also had mine checked and everything was fine - gave birth on due date so it didn't cause problems. But would push to get yours checked just in case x

I had cin2 and the amount I had removed was the size of a thumbnail I think,under general due to being anxious. I fell pregnant 9 months later and received a letter at around 15 weeks asking me to go along for a cervical length check at 21 weeks, I was checked again at 23 weeks due to other issues then 24 weeks and my cervix had shortened by 1cm in a week. I then had progesterone pessaries up until 36 weeks, was signed off at 32 weeks as my cervix was very soft and DD was pretty much engaged, I did however go to 40+5. Definitely push to be checked. My cousin had CIN3 and they didn't book her a consultant appt to be checked until 34 weeks, she ended up having her DS at 33 weeks (,he's absolutely fine).

Hey OP, I had cin 3 and lletz in 2017, fell pregnant 2019 and had DD last August.
I was referred by midwife to see the consultant. There was a whole clinic at my hospital for it and my cervix was measured at 16 weeks, 20 weeks, 21 weeks and I was the put on progesterone pessaries daily as it had shortened a fair bit. I had scans every two weeks after this until growth scans took over at 28 weeks.

I was high risk of pre term labour and my consultant said I’d be lucky to get beyond 33 weeks. I was put on reduced hours and work and home working.
I went into labour at 37 weeks, so made it really far given her predictions!

I had had two pieces removed, together these went over 10mm, they said normally concerns are if the piece is 10mm or above, but as mine was 2 they were concerned as well.

Deffo worth a referral OP,push for it!

I’ve had the LLETZ procedure done under GA last year and mentioned this to my midwife at booking in, I do also have Ashermans syndrome (scarring caused by d&c) that has been treated by 2 lots of surgery and the midwife has said that I will be seen by a consultant.

My booking in was 2 weeks ago and I’ve not heard anything since but that could be due to covid.

The other thing was that when I mentioned the procedure to my GP she didn’t seem to think i would need to see a consultant as she said that’s normally only the case if you’ve had more than 1 LLETZ, so maybe that’s why you’ve not been referred?

Thanks everyone that's all been a lot of helpful information I really appreciate it. I'm going to ring my gp or failing that colposcopy clinic tomorrow and find out how big the area removed was then push for a scan if it's over 10mm. I have also found a local private scanning place who will do it at last resort but its £140 🤯.

Hey Loubell19,
I had a similar story but with CIN II some years ago.
I am now pregnant and have been feeling so anxious about this, I had my cervix measured at the 12 weeks scan and it was 32mm.. they said it was fine but the idea of waiting 8 weeks till the 20 weeks scan to get measured again really gave me so much anxiety! I called the midwife many times and after really insisting they eventually agreed to give me a cervical scan at 16 weeks. My cervix had only shortened 2mm so it was still ok, but I felt so much more relaxed just thinking I did the right thing..I think you should really insist to get it checked, don’t go private, you have the right reasons to be worried.