Colposcopy in Evaluating Bleeding During the Second and Third Trimesters: Short-Term and Postpartum Implications

Area of Science:

• Obstetrics and Gynecology
• Colposcopy and Cervical Cytology

Background:

• Vaginal bleeding in pregnancy can stem from obstetric or non-obstetric sources.
• Colposcopy is not routinely used for second or third-trimester bleeding without a clear obstetric cause.
• This study evaluated colposcopy's role in diagnosing such cases.

Observation:

• A retrospective analysis included 168 patients with second or third-trimester bleeding and no identified obstetric cause.
• Colposcopy findings included abnormal results, ectropion, polyps, and vaginal varices.
• Postcoital bleeding (PCB) was reported by 17.3% of patients.

Findings:

• Colposcopy identified the source of bleeding in 13.7% of cases.
• One patient was diagnosed with high-grade cervical intraepithelial neoplasia (CIN 2-3) and HPV infection.
• Cervical cytology testing played a role in diagnosis.

Implications:

• Colposcopy can be a useful tool for investigating vaginal bleeding of undetermined obstetric origin during pregnancy.
• The findings support incorporating colposcopy into the evaluation of specific pregnancy-related bleeding cases.
• Further research may clarify optimal protocols for colposcopy use in pregnancy.