A 29-year-old woman undergoes LLETZ for CIN 3. She later wishes to know her obstetric risk. Which characteristic of the excised specimen most strongly predicts subsequent preterm birth?
- A Excision depth greater than 10 mm ✓
- B Presence of positive ectocervical margins
- C Involvement of glandular crypts
- D Use of a ball electrode for haemostasis
Correct answer: A. Excision depth greater than 10 mm
Explanation
Meta-analyses show the risk of preterm birth and low birth weight rises significantly once excisional depth exceeds about 10 mm, because removal of deep stroma weakens cervical competence. Margin status determines persistence or recurrence of dyskaryosis, not obstetric outcome, and crypt involvement affects recurrence risk only. This underpins the practice of tailoring excision depth to the extent of the lesion.
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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