Cervical cancer caused by infection with human papillomavirus remains a leading cause of death from cancer in women worldwide.1 Premalignant lesions detected by screening are often treated by excision or ablation. Excisional techniques include cold knife conisation, laser conisation, and large loop excision of the transformation zone. Commonly used ablative techniques include laser ablation and cryotherapy, which destroy superficial tissue. All of these techniques are effective. Many women of childbearing age undergo these treatments, so their effect on subsequent pregnancies is important. Two linked studies assess the outcomes of pregnancy after treatment for premalignant lesions of the cervix (cervical intraepithelial neoplasia).2 3

In a registry cohort study from Norway (doi: 10.1136/bmj.a1343), Albrechtsen and colleagues found that women who had undergone cervical conisation had a significantly higher risk of preterm delivery in subsequent pregnancies than those who had the treatment after delivery and those who were never treated. …