Pregnancy and abnormal cervical cells
This page is about abnormal cervical cells and pregnancy. There is information about
Pregnancy and abnormal cervical cells
We hope the following information will help put your mind at rest. But it is no substitute for talking to your own doctor. Remember that abnormal cells are pre cancerous. They are not cervical cancer.
Cervical screening tests are not usually carried out during pregnancy. But you may be asked to have one at your first antenatal appointment if you had an abnormal cervical screening test result before you became pregnant. In this situation if your smear shows abnormal cells you will not usually have any treatment during your pregnancy. Your doctor may ask you to go for a colposcopy, which won't harm the pregnancy at all. If the cells haven't gone back to normal after the birth, you can have treatment then. The abnormal cells are not likely to change much during this delay.
Pregnancy after treatment for an abnormal smear
After cone biopsy there is a very small chance that the cervix can become so tightly closed that sperm cannot get in. So you would not be able to get pregnant naturally. It is very unlikely that any other cervical treatments will affect your ability to get pregnant in the future.
Women who have had a cone biopsy are slightly more likely to have their babies born before 37 weeks. There is also a slightly increased risk of early birth after having a LLETZ.
You can view and print the quick guides for all the pages in the treating abnormal cervical cells section.
We hope the following information will help put your mind at rest. But it is best to talk to your own doctor, who is in the best position to answer your questions.
The NHS cervical screening programme recommends that in most cases women should not have cervical screening tests if they are, or could be, pregnant. Pregnancy can make the result of the test harder to interpret and it is likely to be inaccurate.
If you are planning to become pregnant, it is a good idea to check with your GP that you are up to date with your cervical screening. Then you can have the test and any treatment necessary before you become pregnant.
If you are already pregnant, and are due to have a cervical screening test, you can usually wait to be screened until 3 months after your baby is born. When you are invited for your test, you should let your GP or clinic know that you are pregnant. They will postpone the test until after the baby is born.
If you have previously had an abnormal result from a cervical screening test, you may need to have another screening test while you are pregnant. Your GP or midwife may ask you to have the test at your first antenatal appointment. This test will not interfere with your pregnancy. If the results come back abnormal, or if a test you had just before you became pregnant shows abnormal results, you don't need to worry. This doesn't mean that you have cancer, but that there are some abnormal cells that can be easily treated a few months after the birth.
You may need to have a colposcopy (a close examination of your cervix and vagina). This examination is safe to have during pregnancy, and your doctor can see how much the cells on your cervix have changed.
If you only have mild changes to the cells on your cervix (CIN 1), you will not need to have any treatment until around three months after your baby is born. After that, you may have another colposcopy to check the cervical cells again. In many women with mild changes, they go back to normal without any treatment. But if the cells are more abnormal (CIN 3), your doctor may ask you to have another colposcopy when you are approximately six months pregnant to keep an eye on them. The abnormal cells are not likely to change much over the time of your pregnancy.
If the cells on your cervix have not gone back to normal after you have given birth, you may then have treatment to remove them. You can discuss your treatment options and any worries you have with your GP and midwife. It is important to make sure that you go to all of your follow up appointments after you have had your baby.
Remember - if your doctor tells you that you have abnormal cells or CIN 1, 2 or 3, you do not have cervical cancer. You have a pre cancerous condition that can easily be treated.
If you are pregnant and your colposcopy shows that the CIN has started to turn into an invasive cancer, your doctor will need to take a tissue sample, probably by loop diathermy or LLETZ. These are procedures where the doctor uses a small metal loop with an electric current, to cut out a small piece of the cervix. But your specialist will not do this unless it is absolutely necessary.
We have separated cone biopsy out, because it can cause particular problems. But these are not common. Firstly there is a very, very small chance that the cervix can become so tightly closed after cone biopsy that sperm cannot get in at all. This is called cervical stenosis. If this happened, you would not be able to get pregnant naturally. If you are having periods after a cone biopsy you have not got complete cervical stenosis. If the lining of the womb can get out, when it is shed as a period, then sperm can get in.
Researchers looked at all the studies on effects of treatment of CIN or stage 1A cervical cancer and published their findings as a systematic review in the Lancet journal in 2006. The review found that some treatments can lead to a small risk of complications in future pregnancies. Women who had a cone biopsy were slightly more likely to have their babies born before 37 weeks. And the risk of low birthweight (less than 2.5 kg) was a bit higher. There was also an increase in birth by Caesarean section for women who had cone biopsy.
You may have an increased risk of early birth because the cone biopsy has weakened your cervix. The cervix is really a muscle that keeps the entrance to the womb closed unless you are in labour. In some women who have had a cone biopsy, there is a risk that the cervix may start to open too soon because of the weight of the growing baby. Serious problems can usually be prevented. If your doctor thinks your cervix may start to open too soon, you can have a sort of running stitch put around it to hold it shut. Your doctor may call this a purse string suture. The stitch is cut before you go into labour, usually at about week 37 of your pregnancy. The cervix can then open normally for the baby to come out.
Some people have reported labour being longer in women who have had cone biopsy because the cervix takes longer to open. But this has not been confirmed by research.
It is very unlikely that any other treatment for abnormal cells, such as laser therapy, diathermy, cold coagulation or cryotherapy will affect your ability to get pregnant in the future. A review of studies into pregnancy after treatment for abnormal cells found that LLETZ (large loop excision of the transformation zone) treatment showed a small rise in risk of birth before 37 weeks (pre term delivery) and having a low birthweight baby (less than 2.5 kg). There was also a slight increase in the risk of waters breaking early (premature rupture of membranes) for women who had this treatment. The review also showed that the amount of cervical tissue removed affected risk. The risk of having a pre term birth was higher for women who had treatment that was deeper than 10 mm.
There have been reports of laser treatment causing a lack of mucus in the cervix, making it more difficult to get pregnant (because this would affect sperm swimming up into the womb). But a lot of research has been done, and this has never been shown to be true. There were no differences in pregnancy rates between women who had or hadn't had laser treatment in any of the studies.
The most likely way that treatment for abnormal cervical cells can affect your ability to get pregnant, is if you got an infection after you were treated. And if the infection then spread up into your fallopian tubes. Infection in the fallopian tubes can cause them to become blocked. If both your tubes are blocked, then you cannot get pregnant because your eggs cannot travel down the tubes into the womb.
Such a severe infection is unlikely after treatment for an abnormal smear. If you do have any symptoms of infection after treatment such as
- Heavy bleeding, especially if more than during your period
- A vaginal discharge that smells or is green or yellow in colour
- Period like pains that last more than a day or two
then go straight back to your doctor. You may need antibiotics which should clear the problem up before the infection can spread and do any damage.
You may feel worried about these risks, but do bear in mind
- The risk of developing serious side effects during pregnancy is small
- If you have cervical abnormalities, having the necessary treatment is very important
- Your doctor will talk through the treatment options, and discuss any potential risks to future pregnancies
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