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Cervical Dysplasia Diagnosed in Pregnancy - A Pre- and Postpartum Analysis
Carsten Hagenbeck1, Martina Helbig1, Luisa Brandi1,2
1Department of Obstetrics and Gynecology, Heinrich Heine University Düsseldorf, Medical Faculty and University Hospital, Düsseldorf, Germany.
Background/Purpose:
Cervical lesion regression and persistence rates are notably high. This study aims to analyse postpartum changes in cervical dysplasia diagnosed during pregnancy. Furthermore, the impact of age, tobacco use, and mode of delivery on cervical findings was assessed as the existing data is inconclusive.
Methods:
This retrospective analysis included pregnant women diagnosed with cervical dysplasia, with complete pre- and postpartum colposcopy, cytology, and histological findings, along with HPV status. Postpartum rates of regression, persistence, and progression were determined and the influence of age, tobacco use, and mode of delivery on cervical preneoplastic lesions was analysed using ordered logistic regression.
Results:
The study included 102 patients treated between 2010 and 2015 with complete pre- and postpartum cytology and/or biopsy data. Postpartum evaluation showed a regression rate of 45.1%, persistence in 52%, and progression in 2.9%. No significant influence on these rates was observed for age (p = 0.255), tobacco use (p = 0.310), or mode of delivery (p = 0.217).
Conclusion:
Our findings support the recommended conservative approach of managing cervical lesions during pregnancy which advocates for continuation of the pregnancy with regular monitoring and postpartum surgery if necessary. If invasive cancer can be excluded, the mode of delivery should be based on obstetric criteria, irrespective of cervical findings.
