Previous CGIN...lots of questions

Hi there,

 

About this time last year I had an abnormal smear and colp which showed CGIN. Had a lletz and got a letter which said all the abnormal cells had been removed, and discharged me back to my GP for a 6 month follow up smear. This was normal. Soon after that follow up, I fell pregnant.

Here are my questions:

I have seen many people say they are monitored more closely after lletz due to shortening of the cervix. I have spoken to 2 midwives about this and neither are interested. I have only had one treatment but I have no idea how much of my cervix was removed (and nor do they!) Do I/Can I push this any further? Or would you take them at their word that it isn't a problem?

Secondly, I only received a normal smear. Should I have received a 'brush and broom' smear as I had CGIN?? Again, should I follow this up??

Finally, I will be due my next follow up smear when I am about halfway through my pregnancy. Would you have the smear? One midwife has told me not to worry which the other has said it is up to me. I know I wouldn't have treatment, but if it was abnormal at least I could be monitored closely? Having said that, I obviously don't really want the stress for half of my pregnancy. What would you do?!

 

I think I will talk to my GP about my concerns but thanks to anyone who can help in the meantime.

Hi, just over 2 years ago i went for a routine smear and the results came back as abnormal so i went and had the lletz with a colposcopy at hospital and they thought it was all gone. They sent the biopsy away and it came back as CGIN and it wasnt gone and they said they wouldnt be able to access it while i was awake so i had to get knocked out and have a general while the cone biopsy was done.

I have been back for follow ups at the colposcopy unit once a year and so far ive been all clear.

I have now got pregnant and been to my doctors so i can get referred to a midwife and she is referring me as urgent and high risk and requesting they see me asap due to my previous treatment.

I am wondering if your notes say that they did the lletz but only took a small amout of your cervix off so therefore not an issue now you are pregnant. Im sure your notes will say exactly what they have done when you had the lletz procedure so hopefully there is no increased risk with your pregnancy but id go talk to your gp and confirm everything.

Hi Citrus,

sorry for the late response. First of all, congratulations on the good news!! I understand your worries and I think probably an important question is how much of your cervix has been taken out. I would call your colposcopy nurse and request this information. Do not take your widwives' opinion as a definite - I have had the experience that they may be badly prepared and if I was in your case I would insist seeing an actual medical practitioner rather than a midwife, and given that you have had LLETZ treatment recently, this is a very legitimate request. Depending on the length and size of your cervix and how much has been removed during LLETZ, it could be that later on in your pregnancy you may have to have a stitch inserted (this seems to be a minor procedure and would normally be done under short GA) to avoid any risk of preterm delivery, which appears to be higher in women who have undergone LLETZ. This is also another reason for why it is important for you to talk to an actual doctor. Please do let me know how it all turns out for you as I am very interested in your GP's/practitioner's response. I would also like to stress that if you feel the need to see a doctor about things like this, do it! It is your and your baby's health and I'd rather annoy doctors/midwives with phone calls than having to deal with potential problems in the future. I hope all goes well for you! xx