Document Detail


Management and evolution of cervical intraepithelial neoplasia during pregnancy and postpartum.
MedLine Citation:
PMID:  12128266     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the evolution of cervical intraepithelial neoplasia (CIN), and to evaluate the safety of cytological and colposcopical surveillance of women with CIN during pregnancy. STUDY DESIGN: Ninety-eight women with antenatal cytological and/or colposcopical impression of CIN were followed up during pregnancy with cytology and colposcopy every 2 months. A cytological and colposcopical reevaluation 2 months postpartum was done, and large loop excision of the transformation zone (LLETZ) was performed if appropriate. Punch or loop biopsies were only taken if there was suspicion of microinvasion. RESULTS: In 14 of 39 (35.9%) and in 25 of 52 (48.1%) women with antenatal impression of CIN I and CIN II-III, respectively, there was postnatal impression of regression. Seven women with findings suspicious of microinvasion underwent small loop biopsies during pregnancy, but early stromal invasion (< 1 mm) was seen in just one case. There was one more case of microinvasion (1.5 mm) diagnosed postnatally in which the antenatal impression was of CIN III. 84.6% of the women with regression compared to 67.3% of the women with stable disease or progression had a vaginal delivery (P = 0.057). CONCLUSION: There is a considerable regression rate of CIN after pregnancy possibly attributable to the loss of the dysplastic cervical epithelium during cervical ripening and vaginal delivery. Frequent cytological and colposcopical evaluation seems to be safe. Small loop biopsies are recommended in cases of possible microinvasion.
Authors:
Evangelos Paraskevaidis; George Koliopoulos; Sophia Kalantaridou; Lambrini Pappa; Iordanis Navrozoglou; Kostas Zikopoulos; Dimitrios E Lolis
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  104     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-19     Completed Date:  2003-02-20     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  67-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics & Gynecology and Cytology Laboratory, Ioannina University Hospital, Ioannina, Greece. gkoliopoulos@aol.com
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MeSH Terms
Descriptor/Qualifier:
Cervical Intraepithelial Neoplasia / etiology,  pathology,  therapy*
Colposcopy
Delivery, Obstetric / methods
Female
Humans
Papillomavirus Infections / diagnosis
Perinatal Care / methods*
Postpartum Period
Pregnancy
Pregnancy Complications, Neoplastic / etiology,  pathology,  therapy*,  virology
Tumor Virus Infections / diagnosis
Uterine Cervical Neoplasms / etiology,  therapy*,  virology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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