Since the publication by M. Kyrgiou on behalf of our Cochrane group in the Lancet 2006 on the impact of excisional treatment on obstetric outcomes, there have been a plethora of publications surrounding this issue.   After the recent BMJ systematic review by our group published ten years later, I aim to summarise the latest evidence  not only obstetric but also first trimester sequalae.  I will also the present the evidence for such sequalae from Quality Assured colposcopy units embedded in the NHS cervical screening programme and the influence such evidence has colposcopy practice.