The importance of previous cervical surgery as one of the risk factors of spontaneous preterm labour and delivery is now widely recognised In 2019 the Reducing Preterm Birth Guidance for Commissioners and Providers document was published by the UK Preterm Clinical Network This became the foundat ID: 1044408
Download Presentation The PPT/PDF document "Why must it be so difficult to find the ..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. Why must it be so difficult to find the depth of the LLETZ?The importance of previous cervical surgery as one of the risk factors of spontaneous preterm labour and delivery is now widely recognised. In 2019 the "Reducing Preterm Birth Guidance for Commissioners and Providers" document was published by the UK Preterm Clinical Network. This became the foundation of element 5 of the Saving Babies Lives Care Bundle (version 2). One of the intermediate risk factors has been identified as history of significant cervical excisional event i.e. LLETZ where more than 10mm depth removed, or more than one LLETZ procedure carried out or cone biopsy. Doctors and midwives are expected to have this information at hand during the risk assessment of pregnant people.The NHS Cervical Screening Programme (Colposcopy and Programme Management) guideline advises to aim removing 7-9mm, 10-15mm or 15-25mm depth for CIN with Type I, Type II and Type III cervical transformation zone respectively. Women of reproductive age should have less than 10mm depth removed in cases of Type I cervical transformation zone. The current colposcopy guidelines and standards acknowledge the risk of preterm birth and late miscarriage, but do not advice how to share this information with the patients. There is no requirement to inform the patient or the GP about the depth of the removed tissue and whether at high risk of preterm delivery as a consequence. For that reason it is difficult to gain reliable information about the type and number of procedures carried out and the removed cervical tissue for the risk assessment.The goal of the below survey is to organise a workgroup under the umbrella of the Preterm Clinical Network and so establish best practice and optimal communication nationwide about cervical surgery related risk.References:1. Saving Babies’ Lives Version Two: A care bundle for reducing perinatal mortality; First published: 15 March 2019Last updated:16 September 2020https://www.england.nhs.uk/publication/saving-babies-lives-version-two-a-care-bundle-for-reducing-perinatal-mortality/2. Cervical screening: programme and colposcopy management; Published: 3 May 2010; Last updated: 28 September 2021https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management 3. NHS Cervical Screening Programme Colposcopy and Programme Management NHSCSP ; Publication number 20; Third Edition March 2016 https://www.bsccp.org.uk/assets/file/uploads/resources/NHS_Cervical_Screeing_Programme._Publication_Number_20_-_Third_Edition.pdfF Attila Vecsei M.D. Consultant Obstetrician and GynaecologistUniversity Hospitals Sussex NHS Foundation Trust, St. Richard’s Hospital, ChichesterUse this link to complete the 10-question survey (max 3 minutes):https://www.surveymonkey.co.uk/r/ZHMGKZFContact me for further details on: attila.vecsei@nhs.netScan the QR code to complete the 10-question survey (max 3 minutes):