Document Detail


High-grade cervical squamous intraepithelial lesion during pregnancy.
MedLine Citation:
PMID:  12195765     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS AND BACKGROUND: An increasing incidence of high-grade squamous intraepithelial lesion (HSIL) has been observed among young women. Consequently, an increased number of cases are being discovered during pregnancy. We analyzed the clinical and therapeutic management of HSIL during pregnancy. METHODS: A retrospective study was conducted from 1979 to 1998, and 58 registries of women with a cytological or histological diagnosis of HSIL during the pregnant-puerperal period were reviewed. Information obtained from medical records included age, gestational age at diagnosis, parity, age of first intercourse, number of sexual partners before pregnancy, tobacco use, cytologic and colposcopic findings, route of delivery, postpartum follow-up, and treatment. This information was compared with a non-pregnant control group with HSIL. RESULTS: The average age of pregnant women with HSIL was 27.9 +/- 5.2 years. The cytologic or histologic diagnosis of HSIL was made in the first trimester in 12 (20.7%) women and in the second trimester in 30 (51.7%) women. Average parity was 2.8 +/- 2 deliveries. Age of first intercourse ranged from 13 to 29 years (16.1 +/- 3.3). Thirty-two women (55.1%) had more than one sexual partner before pregnancy. Thirty-seven (63.8%) refereed tobacco use. According to the aforementioned aspects, no statistical difference was found in relation to control, except to cervical ectopia, which was more frequent in pregnant women (56.9% versus 42.6%). From the total of 58 pregnant women with cytologic or biopsy HSIL diagnosis, 53 had HSIL diagnosis made on cervical biopsy directed by colposcopy performed during the pregnancy; 44 (83%) of them were submitted to conservative management. HSIL was diagnosed by cervical biopsy in postpartum evaluation in 76% pregnant women with vaginal delivery and 78.6% women who underwent cesarean section. CONCLUSIONS: A conservative management of HSIL in pregnancy is proposed, with colposcopic evaluation during gestation and postpartum, regardless of route of delivery.
Authors:
Eddie Fernando Candido Murta; Flávio Henrique Caetano de Souza; Maria Azniv Hazarabedian de Souza; Sheila Jorge Adad
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Tumori     Volume:  88     ISSN:  0300-8916     ISO Abbreviation:  Tumori     Publication Date:    2002 May-Jun
Date Detail:
Created Date:  2002-08-27     Completed Date:  2002-10-11     Revised Date:  2008-12-12    
Medline Journal Info:
Nlm Unique ID:  0111356     Medline TA:  Tumori     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  246-50     Citation Subset:  IM    
Affiliation:
Discipline of Gynecology and Obstetrics, Faculty of Medicine of Triângulo Mineiro, Uberaba, MG, Brazil. eddiemurta@mednet.com.br
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Biopsy
Carcinoma, Squamous Cell / diagnosis*,  pathology,  therapy
Cervical Intraepithelial Neoplasia / diagnosis*,  pathology,  therapy
Colposcopy
Female
Humans
Middle Aged
Pregnancy
Pregnancy Complications, Neoplastic / diagnosis*,  pathology,  therapy
Retrospective Studies
Uterine Cervical Neoplasms / diagnosis*,  pathology,  therapy

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