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Cervical dysplasia in pregnancy: a multi-institutional evaluation
Amanda N Fader1, Erin K Alward, Amy Niederhauser
1Department of Obstetrics and Gynecology, Greater Baltimore Medical Center/Johns Hopkins Medical Institutions, Baltimore, MD 21204, USA. amandanfader@gmail.com
American Journal of Obstetrics and Gynecology
|June 5, 2010
Summary
Cervical dysplasia diagnosed during pregnancy often regresses postpartum, particularly in non-smokers. Biopsies may not be necessary unless invasive cancer is suspected, simplifying management for pregnant individuals.
Area of Science:
- Gynecology
- Obstetrics
- Oncology
Background:
- Cervical dysplasia is frequently diagnosed during pregnancy.
- Management strategies require careful consideration due to pregnancy.
Purpose of the Study:
- To identify prognostic indicators for postpartum regression of cervical dysplasia diagnosed during pregnancy.
- To evaluate the necessity of cervical biopsies in pregnant patients.
Main Methods:
- Retrospective cohort study of 1,079 pregnant women undergoing colposcopy between 2004-2007.
- Analysis of colposcopic impressions, biopsy results, and postpartum follow-up data.
Main Results:
- Colposcopic impression correlated with biopsy results (CIN 1: 83%, CIN 2/3: 56%).
- Postpartum follow-up in 57% of patients showed 61% regression of cervical dysplasia.
- Smoking was inversely associated with dysplasia regression (P = .002).
- No progression to invasive cancer occurred during pregnancy.
Conclusions:
- Expert colposcopy in pregnancy correlates well with biopsy and postpartum findings.
- A significant proportion of cervical dysplasia regresses spontaneously after delivery.
- Cervical biopsies during pregnancy may be deferred unless invasive cancer is suspected.
