A study on the cervical epithelium of women in early pregnancy - histological findings and human papillomavirus characterization.
OBJECTIVE
To study the histological findings of the uterine cervix of women in early pregnancy and to compare them to a control group of nonpregnant women. In cases with morphology compatible with human papillomavirus (HPV) infection, DNA in situ hybridization (ISH) for the types 6, 11, 16, 18, 31 and 33 was performed.


METHODS
The study involved 250 women, aged between 14 and 45 years (mean 26.5 years), of whom 166 were pregnant (up to 12 weeks of gestation, admitted for abortion), and 84 were nonpregnant. Target cervical biopsy was taken from all of them, and the biopsy spot was defined according to the presence of atypical colposcopic findings or from a preliminary chosen part. In the cases with histological results showing the presence of HPV infection (according to Reid criteria), DNA-ISH was carried out. The statistical processing of the obtained results was performed with the SPSS/PC + v.5.01 for Windows, the selected level for statistical significance being at p= 0.05.


RESULTS
The histological findings from the material suitable for assessment showed morphology compatible for HPV infection in 29 (17.7%) pregnant and 11 (13.1%) nonpregnant women. At the same time, precancerous lesions with or without HPV infection were found in 43 pregnant women, of whom 40 (24.4%) with CIN I-II and 3 (1.8%) with CIN III, and in the group of nonpregnant women in 20, of whom 17 (20.2%) with CIN I-II and 3 (3.6%) with CIN III. Microinvasive cancer was detected in one patient of the control group. DNA-ISH was performed to all 54 women with histology compatible with HPV infection (33 pregnant and 21 nonpregnant).


CONCLUSIONS
We believe that the significant difference of the histological findings between pregnant and nonpregnant women is basically due to the 4-fold higher incidence of normal findings in nonpregnant women and, to a lesser extent, to the higher frequency of HPV lesions and low grade CIN (I and II) in pregnant women. The distribution of the investigated viral types with DNA-ISH did not show any difference between the two investigated groups.
Zlatkov
V
V
Department of Gynecology, National Transport Hospital, Sofia, Bulgaria.
Kostova
P
P
Makaveeva
V
V
Ganchev
G
G
Danon
S
S