Colposcopy monitoring in pregnancy complicated by CIN and early cervical cancer.
The aim of the study was the evaluation of the role of colposcopy in the diagnosis, monitoring and treatment qualification of CIN and early cervical cancer in pregnancy. Thirty pregnant women with these lesions aged 25-39 years were diagnosed and observed with the use of colposcopy as the first diagnostic step supplemented by cytology and directed biopsy. In 26 cases of CIN and 2 cases of microcarcinoma, conization was performed at the earliest 6 weeks after delivery. Three groups of lesions were distinguished: 1) progressive, including 2 (6.6%) cases of CIN progressing to microcarcinoma; 2) regressive, including 6 (20%) cases of CIN3a, and 3) stationary, including 20 (66%) cases of CIN1-3 and 2 cases of microinvasion. The majority of women were followed up for 7-35 weeks, including the course of pregnancy and 6 weeks prior to treatment. The follow-up after treatment was determined firstly every 3, then 6 and finally every 12 months. Concluding, colposcopy with directed biopsy and complementary cytology can be regarded as the best management strategy in the diagnosis of CIN and early cervical cancer in pregnancy, as well as in monitoring and treatment qualification of these patients after vaginal delivery. CIN of all grades, and some cases of early invasion which do not have progressive tendencies can be treated 6 weeks after delivery, chiefly by means of diagnostic-therapeutic conization.
Madej
J G
JG
Department of Gynecology and Oncology, Collegium Medium Jagiellonian University, Cracow, Poland.
D000328:Adult; D002277:Carcinoma / Q000175:diagnosis / Q000601:surgery; D003127:Colposcopy; D005260:Female; D006801:Humans; D008991:Monitoring, Physiologic; D049590:Postpartum Period; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000601:surgery; D011256:Pregnancy Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000601:surgery