Postpartum outcome of cervical intraepithelial neoplasia in pregnant women determined by route of delivery.
Cervical intraepithelial neoplasia (CIN) has its highest incidence during women's reproductive years. During 2 sequential 7-year periods, 1994 to 2000 and 2001 to 2007, 3695 and 3894 deliveries were performed, respectively, at Osaka University Hospital. CIN was detected in 21 cases (0.57%) during 1994-2000 and in 43 cases (1.1%) during 2001-2007. By comparison, cervical intraepithelial neoplasia-complicated pregnancies increased significantly in the latter period (P = .015 by Fisher exact test, Odds ratio = 1.95; 95%CI: 1.16-3.30). We observed CIN regression in 34 (76%) of 45 cases of vaginal delivery and in 6 (50%) of 12 cases of cesarean delivery, indicating that the outcome of an initially diagnosed CIN and the delivery routes appeared not to be significantly related. However, a different result was obtained when only those patients whose CIN lesions persisted until the delivery were analyzed. Among the 35 such cases in the vaginal delivery group, 24 cases (69%) regressed after the delivery; in 8 such cases from the cesarean delivery group, only 2 cases (25%) regressed afterward. Our study clearly shows that pregnancy complicated with CIN is increasing rapidly in Japan. We also find that there is a significantly more frequent postpartum regression of biopsy-proven CIN lesions following a vaginal delivery compared to cesarean section (P = .042 by Fisher exact test, Odds ratio = 6.55; 95% CI: 1.13-37.8).
Ueda
Yutaka
Y
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
Enomoto
Takayuki
T
Miyatake
Takashi
T
Yoshino
Kiyoshi
K
Fujita
Masami
M
Miyake
Takahito
T
Fujiwara
Kazuko
K
Muraji
Miho
M
Kanagawa
Takeshi
T
Kimura
Tadashi
T
D000328:Adult; D001706:Biopsy; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D009365:Neoplasm Regression, Spontaneous / Q000473:pathology; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000473:pathology*; D049590:Postpartum Period; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology*