Document Detail


Management of the abnormal Papanicolaou smear and colposcopy in pregnancy: an evidenced-based review.
MedLine Citation:
PMID:  22481624     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Women diagnosed with abnormal Papanicolau smears or cervical abnormalities during pregnancy present a challenge to health care providers, as conventional management guidelines appropriate for the non-pregnant population may be contraindicated. The physiologic effects of pregnancy that may result in greater difficulty with the colposcopic examination include increased cervical mucus production that may obscure visualization, cervical hyperemia, gland prominence, and eversion of the columnar epithelium. The squamo-columnar junction may also be difficult to visualize in early pregnancy, but will often evert as the pregnancy continues. Because of these changes, cervical dysplasia may have a more prominent appearance in the gravid patient. Therefore, colposcopy should be performed by a skilled examiner with expertise in the cervical changes of pregnancy. The primary goal of colposcopy during pregnancy is to exclude the presence of invasive cancer, and thus, many cervical lesions may be followed with serial cytology and colposcopy during pregnancy or by deferring further colposcopic examination until the postpartum period. Cervical biopsy should be avoided unless a malignancy is suspected and endocervical sampling is contraindicated. Herein, we present a contemporary, evidence-based review of the colposcopic examination and guidelines for triaging and evaluating abnormal cervical cytology and lesions that are diagnosed during pregnancy.
Authors:
A C Fleury; M L Birsner; A N Fader
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Minerva ginecologica     Volume:  64     ISSN:  0026-4784     ISO Abbreviation:  Minerva Ginecol     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400731     Medline TA:  Minerva Ginecol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  137-48     Citation Subset:  IM    
Affiliation:
Department of Gynecology, Greater Baltimore Medical Center, Baltimore, MD, USA - amandanfader@gmail.com.
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