High-grade cervical squamous intraepithelial lesion during pregnancy

Area of Science:

• Gynecology
• Obstetrics
• Oncology

Background:

• Increasing incidence of high-grade squamous intraepithelial lesion (HSIL) observed in young women.
• A growing number of HSIL cases are diagnosed during pregnancy.
• Analysis of clinical and therapeutic management of HSIL in pregnant individuals is crucial.

Purpose of the Study:

• To analyze the clinical and therapeutic management of HSIL diagnosed during pregnancy.
• To compare HSIL management in pregnant women versus a non-pregnant control group.
• To evaluate the effectiveness of conservative management strategies for HSIL in pregnancy.

Main Methods:

• Retrospective review of 58 registries of women with HSIL during the pregnant-puerperal period (1979-1998).
• Data collected included patient demographics, gestational age at diagnosis, parity, sexual history, tobacco use, cytologic and colposcopic findings, delivery route, and postpartum follow-up.
• Comparison with a non-pregnant control group with HSIL.

Main Results:

• Average age of pregnant women with HSIL was 27.9 years; diagnosis often occurred in the second trimester (51.7%).
• No significant statistical differences found compared to controls, except for higher prevalence of cervical ectopia in pregnant women (56.9%).
• Conservative management was employed in 83% of pregnant women diagnosed with HSIL via colposcopy-directed biopsy; postpartum diagnosis occurred in 76-78.6% regardless of delivery route.

Conclusions:

• Conservative management of HSIL during pregnancy is proposed.
• Colposcopic evaluation during gestation and postpartum is recommended for pregnant individuals with HSIL.
• Management approach should be consistent regardless of the route of delivery.