Contact hysteroscopic evaluation of the endocervix as an adjunct to colposcopy

A total of 66 women with cervical intraepithelial neoplasia extending into the endocervical canal were investigated by endocervical curettage, contact endoscopy, and conization biopsy of the cervix. Although atypical epithelium was obtained in only 8 women by blind endocervical curettage, contact endoscopy identified 42 instances of disease of equal or greater magnitude than determined by the original ectocervical colposcopic evaluation. These findings were subsequently confirmed by conization biopsy. As the 6-mm contact hysteroscope may easily be inserted into the pregnant cervix, sufficient reassurance may be gained to avoid endocervical curettage or cone biopsy and thus to avoid the hazard of major hemorrhage and/or pregnancy interruption.