title: Premalignant disease in the genital tract in pregnancy.
abstract: Cervical intraepithelial neoplasia (CIN) is the most common premalignant disease of the lower genital tract encountered during pregnancy. As in the non-pregnant state, abnormal cytology should be referred for colposcopy. However, the role of colposcopy in pregnant women is to exclude invasive cancer by visual inspection and defer biopsy and definitive treatment until the post-partum period. Colposcopic exclusion of invasive disease is the only absolute indication for conisation in pregnancy. It is now evident that treatment for CIN outside of pregnancy, that involves >15 mm deep excision is associated with an increased risk of preterm delivery. Vulval intraepithelial neoplasia (VIN) and vaginal intraepithelial neoplasia (VaIN) rarely present in women of childbearing age; nevertheless, medical management should be postponed until after delivery, unless symptoms are particularly severe.
authors.affiliation: Institute of Cancer Sciences, The University of Manchester, St Mary's Hospital, Manchester, UK.
authors.forename: Gemma L
authors.initials: GL
authors.lastname: Owens
authors.affiliation: Institute of Cancer Sciences, The University of Manchester, St Mary's Hospital, Manchester, UK. Electronic address: Henry.kitchener@manchester.ac.uk.
authors.forename: Henry C
authors.initials: HC
authors.lastname: Kitchener
mesh_terms: D001706:Biopsy; D003127:Colposcopy; D055088:Early Detection of Cancer; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D009361:Neoplasm Invasiveness; D049590:Postpartum Period; D011230:Precancerous Conditions / Q000473:pathology* / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000628:therapy; D011256:Pregnancy Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy; D014625:Vaginal Neoplasms / Q000628:therapy*; D014846:Vulvar Neoplasms / Q000628:therapy*; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000628:therapy
keywords: Cervical intraepithelial neoplasia (CIN); colposcopy; endometrial hyperplasia; pregnancy; vaginal intraepithelial neoplasia (VaIN); vulval intraepithelial neoplasia (VIN)