Cervical dysplasia in pregnancy: a multi-institutional evaluation

Am J Obstet Gynecol. 2010 Aug;203(2):113.e1-6. doi: 10.1016/j.ajog.2010.04.016. Epub 2010 Jun 3.

Abstract

Objective: This study was undertaken to identify the prognostic indicators associated with postpartum regression of cervical dysplasia diagnosed in pregnancy.

Study design: 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.

Conclusion: 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.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Academic Medical Centers
  • Adult
  • Age Distribution
  • Biopsy, Needle
  • Cohort Studies
  • Colposcopy / methods
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Immunohistochemistry
  • Incidence
  • Multivariate Analysis
  • Precancerous Conditions / epidemiology
  • Precancerous Conditions / pathology
  • Pregnancy
  • Pregnancy Complications, Neoplastic / epidemiology*
  • Pregnancy Complications, Neoplastic / pathology
  • Pregnancy Outcome*
  • Prenatal Care
  • Probability
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Uterine Cervical Dysplasia / diagnosis
  • Uterine Cervical Dysplasia / epidemiology*
  • Uterine Cervical Dysplasia / pathology*
  • Uterine Neoplasms / diagnosis
  • Uterine Neoplasms / epidemiology
  • Uterine Neoplasms / pathology*
  • Vaginal Smears
  • Young Adult