Cervical intraepithelial neoplasia during pregnancy

The aim was to analyze the unaffected course of cervical intraepithelial neoplasia (CIN) in pregnant women and to compare the rates of lesion persistence, progression, and regression.

Patients with abnormal cytology included in the study underwent colposcopy, followed by a biopsy of the cervix. At the end of the postpartum period, all patients underwent Pap smear, colposcopy, and endocervical curettage to obtain tissue samples. The findings were compared to the baseline to assess the rates of persistence, regression, and progression of CIN.

The study group were 53 pregnant women. CIN was confirmed in 35 (66%) of them: CIN1 (n = 8, 22.9%); CIN 2+ (n = 26, 74.3%); and stage IA1 cervical cancer (n = 1, 2.9%). At the end of the postpartum period in 50% cases, there was no change compared to the baseline. Progression was seen in 2.9% and regression in 47.1%. A tendency for persistence and spontaneous regression of the lesions was observed.

Although in many cases CIN tends to regress spontaneously after delivery, such outcome is not to be expected in all patients. When invasive cervical cancer has been excluded, definitive treatment for cervical dysplasia may be deferred to the postpartum period without any harm to the mother.