Computerized colposcopy and conservative management of cervical intraepithelial neoplasia in pregnancy.
BACKGROUND
Computerized colposcopy is the noninvasive digital processing of colposcopic images acquired using a charge-coupled device camera. The purpose of this study was to evaluate the clinical applications of computerized colposcopy, and to record the colposcopic changes associated with progression or regression of cervical intraepithelial neoplasia in pregnancy.


METHODS
Forty-one pregnant patients, with abnormal Papanicolaou smears and a fully visualized squamo-columnar junction, were serially monitored throughout their pregnancies using computerized colposcopy. All patients had baseline computer-assisted measurements of their cervical lesions and a repeat measurement at monthly intervals and at 3-months postpartum.


RESULTS
During the period of gestation, 17.1% of lesions increased in size, 21.9% remained unchanged, 41.5% decreased in size and 19.5% disappeared completely. In patients with an increase in lesion size, a colposcopically directed punch biopsy was performed which revealed CIN III but no microinvasion. Cervical biopsy during pregnancy was unnecessary in 82.9% of cases.


CONCLUSIONS
The ability to sequentially monitor and quantify colposcopically visualized lesions, using computerized colposcopy, provides a noninvasive objective mode to evaluate progression, stability, or regression of CIN lesions during pregnancy.
Mikhail
M S
MS
Department of Obstetrics & Gynecology, Albert Einstein College of Medicine, Bronx, New York, USA.
Anyaegbunam
A
A
Romney
S L
SL
D000328:Adult; D001706:Biopsy; D003127:Colposcopy / Q000379:methods*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008423:Maternal Age; D065006:Papanicolaou Test; D010298:Parity; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy