Significance of AGUS Pap smears in pregnant and postpartum women.
OBJECTIVE
To study the clinical significance of atypical glandular cells of undertermined significance (AGUS) in pregnant and postpartum women.


METHODS
We evaluated 35 women who were pregnant (30) or within three months postpartum (5) and had a cytologic diagnosis of AGUS. Twenty-seven (77%) patients had follow-up: 17 (63%) patients underwent colposcopic examination and biopsy, and 10 (37%) had repeat Pap smears. Eight patients were lost to follow-up.


RESULTS
Five (29.4%) patients had a squamous intraepithelial lesion (SIL), including three high grade and two low grade, on subsequent biopsy. The remaining (70.6%) patients had benign pathology, which included 5 chronic cervicitis, 4 endocervical and/or endometrial polyps, 2 Arias-Stella reaction and 1 microglandular hyperplasia. Among the patients with repeat Pap smears, two had persistent AGUS/atypical squamous cells of undetermined significance, the remaining cases were within normal limits.


CONCLUSIONS
Pregnancy-related changes may present with glandular atypia. In addition, about one-third of pregnant and postpartum women with a diagnosis of AGUS had SIL on subsequent biopsy; that rate is similar to that in nonpregnant women. Therefore, pregnant women with a cytologic diagnosis of AGUS should be followed closely.
Chhieng
D C
DC
Department of Pathology, New York University Medical Center, New York, New York, USA. dchhieng@path.uab.edu
Elgert
P
P
Cangiarella
J F
JF
Cohen
J M
JM
D000293:Adolescent; D000328:Adult; D002467:Cell Nucleus / Q000648:ultrastructure; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D065006:Papanicolaou Test; D049590:Postpartum Period; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology* / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000648:ultrastructure; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology / Q000648:ultrastructure