Colposcopic management of abnormal cervical cytology in pregnancy.
Two hundred sixty-five pregnant women with abnormal Papanicolaou smears underwent colposcopy; 248 of them underwent directed cervical biopsies. Correlation of cytology with histology indicated concordancy within one grade in 202 of 241 patients (84%). Cytology was significantly more advanced than directed cervical biopsy in 15% and significantly less advanced in 1%. None of the 163 patients with moderate dysplastic cytology or less had microinvasive or invasive disease. Cervical conization was performed on 23 women, 4 of whom underwent modified radical hysterectomy for microinvasive carcinoma. Sixteen of 18 patients undergoing conization in pregnancy were available for postpartum follow-up and had persistent cervical dysplasia. Of 242 women followed conservatively, without pregnancy conization, 88 underwent postpartum evaluation. There were no false negatives in the antepartum evaluation of malignancy.
LaPolla
J P
JP
Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City.
O'Neill
C
C
Wetrich
D
D
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology; D002584:Cervix Uteri / Q000473:pathology; D003127:Colposcopy; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears