Cervical cytology and conservative management of cervical neoplasias during pregnancy.
To elucidate the clinical significance of cervical cytology during pregnancy, 7,725 pregnant women were examined. Abnormal cytologic findings were recorded in 65 cases (0.8%). Colposcopically directed punch biopsies revealed cervical dysplasia and carcinoma in 27 cases (0.35%). The incidences in a massive examination for 714,119 women in Osaka Prefecture were 1.1% and 0.25%, respectively. Cytologic findings of the patients with cervical neoplasia during pregnancy agreed well (76%) with their histologic findings. Colposcopically, the squamo-columnar junction was visible in many cases, and white epithelium was most commonly observed during pregnancy. Pre- and postpartum follow-up study revealed that progression from dysplasia was seen only in two (20%) of 20 cases. Laser conization was performed on six women during pregnancy, and four were microinvasive carcinoma, all of which underwent normal vaginal delivery without any complication from conization. These results suggest that routine cervical cytology must be performed during pregnancy, and cytologic and colposcopic diagnosis may supply enough data to avoid unnecessary biopsies. Moreover, laser conization is recommended as an excellent diagnostic and therapeutic procedure for women with microinvasive carcinoma during pregnancy.
Ueki
M
M
Department of Obstetrics and Gynecology, Osaka Medical College, Japan.
Ueda
M
M
Kumagai
K
K
Okamoto
Y
Y
Noda
S
S
Matsuoka
M
M
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D003127:Colposcopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053685:Laser Therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery