Cervical dysplasia in pregnancy: a multi-institutional evaluation.
OBJECTIVE
This study was undertaken to identify the prognostic indicators associated with postpartum regression of cervical dysplasia diagnosed in pregnancy.


METHODS
A retrospective cohort study of pregnant women referred for colposcopy from 2004-2007 at four academic centers.


RESULTS
One thousand seventy-nine patients were identified. Colposcopic impression by cervical cytology is detailed later in the text. Of patients who underwent biopsy, results correlated with or were less severe than colposcopic impression in 83% with CIN 1 and 56% with CIN 2/3. Fifty-seven percent had follow-up postpartum, with 61% reverting to normal. Resolution of cervical dysplasia was inversely associated with smoking (P = .002). No progression to cancer occurred during pregnancy.


CONCLUSIONS
Colposcopic impression in pregnancy correlated with cervical biopsy results and postpartum colposcopic findings when performed by expert colposcopists. A high proportion of cervical dysplasia regressed postpartum. Cervical biopsies in pregnancy may not be necessary unless invasive cancer is suspected.
Fader
Amanda N
AN
Department of Obstetrics and Gynecology, Greater Baltimore Medical Center/Johns Hopkins Medical Institutions, Baltimore, MD 21204, USA. amandanfader@gmail.com
Alward
Erin K
EK
Niederhauser
Amy
A
Chirico
Christina
C
Lesnock
Jamie L
JL
Zwiesler
Daniel J
DJ
Guido
Richard S
RS
Lofgren
Darla J
DJ
Gold
Michael A
MA
Moore
Kathleen N
KN
D000046:Academic Medical Centers; D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D015331:Cohort Studies; D003127:Colposcopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D015999:Multivariate Analysis; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology* / Q000473:pathology; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011336:Probability; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D014626:Vaginal Smears; D055815:Young Adult