Document Detail


High-grade cervical neoplasia during pregnancy: diagnosis, management and postpartum findings.
MedLine Citation:
PMID:  22880637     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives. To study the prevalence of high-grade cervical intraepithelial neoplasia (CIN 2-3) during pregnancy and compare the rates of persistence, progression and regression of CIN 2-3 by colposcopically guided biopsy during pregnancy with respect to the postpartum period. Also to assess biopsy results during pregnancy and postpartum in relation to histopathology after treatment of lesions. Population. Pregnant women with a histological diagnosis of CIN 2-3 confirmed by colposcopically guided biopsy during pregnancy. Methods. Between 1989 and 2008, 11700 pregnant women had cytologic and simultaneous colposcopic examinations during pregnancy. A colposcopically guided biopsy was performed when colposcopically suspicious high-grade lesions were detected, regardless of cytological results. Women with a histopathological diagnosis of CIN 2-3 during pregnancy were re-evaluated by colposcopically guided biopsy and treated during the postpartum period. Results. CIN 2-3 was diagnosed in 56 of 11700 (0.48%) pregnant women by biopsy. Thirty women complying with the protocol were assessed postpartum by histopathological studies, of whom 70% exhibited persistence, 13.3% progression and 16.7% regression of CIN 2-3. Twenty-nine were diagnosed by conization and one by colposcopically guided biopsy during the postpartum period, which revealed invasive cervical carcinoma. Conclusions. Due to the high rates of CIN 2-3 persistence during the postpartum period, we suggest that all patients in whom CIN 2-3 was diagnosed during pregnancy are biopsied and eventually treated during the postpartum period, with at least a two-year follow-up control to prevent lesion recurrence.
Authors:
Enrique F Coppolillo; Hilda Malamud DE Ruda Vega; Julieta Brizuela Martha Cora Eliseth; Avelino Barata; Beatriz E Perazzi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-10
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Lower Genital Tract Clinic, Obstetrics Division, Department of Gynecology, Hospital de Clínicas "José de San Martín", University Hospital of Buenos Aires, Buenos Aires, Argentina.
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