High-Grade cervical neoplasia during pregnancy: diagnosis, management and postpartum findings.

ENRIQUE COPPOLILLO; HILDA MALAMUD DE RUDA VEGA; MARTHA CORA ELISEHT; AVELINO BARATA; BEATRIZ PERAZZI

ACTA OBSTETRICIA AND GYNECOLOGICA SCANDINAVICA

TAYLOR & FRANCIS AS

Lugar: Gotemburgo; Año: 2013 vol. 92 p. 293 - 297

0001-6349

Objectives. To study the prevalence of high-grade cervical intraepithelial neoplasia(CIN 2?3) during pregnancy and compare the rates of persistence, progressionand regression of CIN 2?3 by colposcopically guided biopsy duringpregnancy with respect to the postpartum period. Also to assess biopsy resultsduring pregnancy and postpartum in relation to histopathology after treatmentof lesions. Population. Pregnant women with a histological diagnosis of CIN 2?3 confirmed by colposcopically guided biopsy during pregnancy. Methods.Between 1989 and 2008, 11 700 pregnant women had cytologic and simultaneouscolposcopic examinations during pregnancy. A colposcopically guidedbiopsy was performed when colposcopically suspicious high-grade lesions weredetected, regardless of cytological results. Women with a histopathologicaldiagnosis of CIN 2?3 during pregnancy were re-evaluated by colposcopicallyguided biopsy and treated during the postpartum period. Results. CIN 2?3 wasdiagnosed in 56 of 11 700 (0.48%) pregnant women by biopsy. Thirty womencomplying with the protocol were assessed postpartum by histopathologicalstudies, of whom 70% exhibited persistence, 13.3% progression and 16.7%regression of CIN 2?3. Twenty-nine were diagnosed by conization and one bycolposcopically guided biopsy during the postpartum period, which revealedinvasive cervical carcinoma. Conclusions. Due to the high rates of CIN 2?3 persistenceduring the postpartum period, we suggest that all patients in whomCIN 2?3 was diagnosed during pregnancy are biopsied and treated if necessaryduring the postpartum period, with at least a two-year follow-up control toprevent lesion recurrence.