[Teenage pregnancy and routine colposcopy]

The superiority of colposcopy over cytology is clearly demonstrated by the finding of an atypical transformation zone in 42.7% of routine consecutive colposcopies performed on 206 pregnant teenagers 16 years and younger at Paarl Hospital; in only 1.46% of these girls did cervical cytology show atypia or dysplasia. Complete colposcopy was possible in 97.6% of cases whereas cytology was incomplete in 28.2%, with no endocervical cells shown. The colposcopical findings are very similar to those of a concurrent West German study which links these findings to the human papillomavirus notoriously missed by cytology. Colposcopy should be part of the routine evaluation of every teenage pregnancy as cytological examination alone is not only incomplete but also much less sensitive in detecting abnormal change of the cervix.