LLetz 14 mm excision...risk of premature birth?

[sapo2000]

I am 15 weeks pregnant and I've been having some bleeding (dark red). I underwent a LLetz procedure late 2018 and 14 mm were removed. I read that between 10-14 mm is considered to be a medium excision. Should I worry about a premature birth? Any experiences? Thank you.

I had a LLETZ a few years before I got pregnant, though I'm not sure how much they removed.

I mentioned it to my midwife at booking in and she didn't seem to know what I was talking about and said it wouldn't be an issue. She wrote in my notes that I'd had laser removal of some cells, but a LLETZ isn't laser so I got her to correct that in my notes. So basically, not convinced she knew what I was talking about

I had some bleeding in my 3rd trimester which ended up with multiple hospital visits, all was fine when they checked me out and they said you can get bleeding from the cervix in pregnancy in the same way that some women get bleeding gums or nosebleeds.

They did need to check the bleeding to be sure it wasn't coming from my uterus itself which could have meant a much more serious problem with the placenta. And the doctors I saw in the hospital all said it could well have been related to the LLETZ.

In the end baby was born healthy at 39 weeks but I did have a very quick labour for a first time mum and wonder if that's related too. If I have another baby I'd like to see a consultant about my cervix and the LLETZ early on in my pregnancy.

So I would advise, 1. Get your bleeding checked out and 2. Don't be fobbed off by midwives who haven't heard of LLETZ!

Many thanks for your feedback.
Could I also ask what colour was your bleeding? Mine is brownish and dark red.
I went several times to the doctor. No cause was identified.

The midwife should have referral you for extra scans of the cervix as letz along with other things like sections at full dilation for example can put you at risk of premature birth as it can cause incompetent cervix.
They should offer an internal scan one at 16 weeks and another at 21 ish weeks aslong as the first scan measures above 2.5cm if lower at 16 weeks they should offer treatment of a cervical stitch
If on fb have a look at incompetent cervix uk - pregnancy related

Agree, don't be fobbed off and request an internal cervix measurement. I had this done in both my pregnancies following an extensive lletz and both times I had to push for it

My bleeding was bright red and quite pale and diluted. I was quite a lot further along than you are now, though - I think it started at 30 weeks for me.

I would make sure your doctor knows about your LLETZ and ask them as well as your midwife about internal scans. I was annoyed that I went along with the midwife saying the LLETZ wouldn't affect my pregnancy and then when I started bleeding the doctors said it might after all.

You can have a cervix scan between 16 and 24 weeks. In some trusts they do more than one. I only had one at 20 weeks to check the length, I hadn't had any bleeding or signs of concern it was all precautionary.

I would speak to you midwife and if needed call the fetal medical team at your hospital to see what they suggest.

I hope you get some reassurance soon.

To be more accurate, what I have is more like a discharge (daily) than bleeding. I feel like a huge build up internally and about one hour or so later it 'comes out' thick, dark and heavy blood.

Have you contact ur local epu ? I think you have two different issues 1 the bleeding that needs investigating 2 that you have had a good amount of cervix removed so require monitoring/ scans to check for cervical incompetence

I went to my local Epau last Tuesday . They found nothing relevant. The doctor had a quick look at my cervix and she said that I had dark blood in my cervix, but because it was dark, it was not worrying.

If you told the midwife at booking about your lletz then you'll be immediately booked for review with an obstetrician and based on the fact that it was more than 10mm, you'll be sent for a cervix length scan around 20 weeks.

In my Trust they automatically send you for obstetrician review if you've had a lletz. Ring midwife and ensure they know so they can refer you.

For some reason , my midwife never gave me her phone number. I always have to wait for the next Tuesday which is the day she is in the clinic. I will speak to her next Tuesday. I rang the Blenheim college of midwives and never got back to me. If I want anything done, I always call my gp.

Anyway, thank you everyone for your help and feedback. I guess my bleeding might not be cervix related. The cervix bleeding seems to be more watery and very different from what I have now. I see my midwife this Tuesday. However the bleeding still goes on.

I'm so shocked they didn't refer you for a cervix scan after your booking apt. That is what you need. There is a threshold of what the cervix needs to measure, if it's less than a certain length then they may consider a cervical stitch. I had one a couple of weeks ago after a lletz and mine is a good length. Would definitely push for a cervix scan as a precaution

Thank you. I think I have one scheduled in the middle of August. I got a message saying that I have an appointment on the 17 but no details about the location or hour and I can't call the number back. I called the hospital and no one knows about this. I have to make more phone calls on Monday to discover whether this refers to the cervical exam or not.

@sapo2000

Thank you. I think I have one scheduled in the middle of August. I got a message saying that I have an appointment on the 17 but no details about the location or hour and I can't call the number back. I called the hospital and no one knows about this. I have to make more phone calls on Monday to discover whether this refers to the cervical exam or not.

This is exactly what happened to me. When I told midwife at booking in about Lletz she didn't say anything but it automatically triggered a consultant appointment and mine didn't say what it was for either, had to call them. It's great you've got an app so they're definitely on it. You'll be fine x

Thank you. Who/which service did you call exactly? I made several calls and no one knew about this.

Hi, I had some cells removed in the past ( laser cone, not lletz) I told my midwife ar our first appointment, I’ve since had fortnightly scans to check my cervix length as Lletz/laser cone means your chance of a short cervix are higher…