Cervical dysplasia in pregnancy: progression versus regression postpartum

Siddiqui, Gazala; Kurzel, Richard B.; Lampley, E. Charles; Kang, Hyung S.; Josef, Blankstein

doi:10.1016/s0029-7844(01)01157-7

Cited by 16 publications

(20 citation statements)

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“…12 According to a retrospective study conducted in the USA, lesions regressed in 64% of pregnant cases diagnosed with ASCUS and SIL, and lesions were preserved in 34% of pregnant cases. 13 Self-regression after natural delivery correlated with the increase in desquamation of the cervix. Inflammatory component is commonly seen on Pap smears from pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Screening for cervical cancer during pregnancy

Manikkam

2016

Int J Community Med Public Health

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INTRODUCTIONCervical cancer is one of the most common malignancy among females, worldwide.1 Every year, more than 493,000 individuals are diagnosed with and 274,000 die from cervical cancer. The majority of these cases (80%) are experienced in developing countries.2 PAP smear is the most sensitive and specific screening test for cervical cancer in reducing mortality and morbidity of women. However, high incidence and mortality rates continue in developing countries due to the lack of screening programmes. 4 In India it is an important public health problem for women leading to annual mortality of ABSTRACT Background: Carcinoma cervix is the second most common gynaecological cancer causing deaths among women. PAP smear being most sensitive and specific screening test reducing mortality and morbidity, can be used to identify early changes in cervix during pregnancy. The aim of the study was to offer cervical cancer screening for pregnant women and motivate them into the mainstream of screening subsequently and evaluate their acceptance. Also to identify reproductive tract infections, associated pregnancy changes and their effect on pregnancy outcome. This prospective study enrolled 200 normal pregnant patients admitted at Sri Rama Krishna Hospital from September 2012 to January 2014. Methods: All the patients selected for this study underwent history taking and examination .Pap smear was taken with patient in dorsal position. Among 200 cases, 196 (98%) were adequate smears and only 4 (2%) were inadequate. Adequate smears which were grouped as per Bethesda system, majority (97.5%) fell in Group I and were found to be normal or inflammatory smear, while only one showed ASCUS. Of the cases in Group I, 114 cases (57%) showed inflammation while 81 cases (40.5%) were normal. Statistical analysis used was SPSS 11.5. Results: Majority of the patients involved in study were in the age group of 20-35years with only 3.5% below 19yrs and 2% above 35years with mean age of 26.9years. Most of the patients were married at 20-30yrs of age while only 4.5% were married after 30 with mean age of marriage 23.4yrs. Importantly 15% had an early marriage between 15-19yrs. Most of patients who consented for study belonged to third trimester (91.5%) followed second trimester (17%) with average of 32.7wks. About 80% had knowledge regarding screening for cervical cancer. Statistical analysis used was SPSS 11.5. Conclusions: PAP smear being a cost effective, easy to perform test, can be carried out even in pregnant woman. It does not interfere with the natural course of pregnancy and hence safety is ensured. Pregnancy is a potential opportunity to counsel and educate them regarding the significance of screening.

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Section: Discussionmentioning

confidence: 99%

Screening for cervical cancer during pregnancy

Manikkam

2016

Int J Community Med Public Health

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“…According to a retrospective study conducted in the USA, while lesions regressed in 64% of pregnant cases diagnosed with ASC-US and SIL, lesions were preserved in 34% of pregnant cases; for 67% of patients with CIS, lesions were preserved during postpartum (Siddiqui et al, 2001). In another study, where there were abnormal PAP smear results, PAP smear results returned to normal in 46% of cases during postpartum, PAP smear results regressed in 57% of cases during postpartum, and PAP smear results were preserved in 40% of cases during postpartum.…”

Section: Discussionmentioning

confidence: 99%

Pap Smear Screening Results for Turkish Pregnant Women

Dinç

2012

Asian Pacific Journal of Cancer Prevention

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Objective: Cervix cancer is one of the most common gynecological cancer types that cause cancer deaths among women. This study was planned based on a descriptive method in order to evaluate the results of PAP smear screening during pregnancy for prevention of cancer. Materials and Methods: The research involved 110 pregnant women registered at the Obstetrics and Gynecology Polyclinic of Bagcilar Training and Research Hospital and 86 non-pregnant women of the same ages as a control group. As criteria for acceptance were conditions such as not being in coitus within the last 48 hours, not using vaginal ovule, and not performing vaginal lavage. A survey consisting of 33 questions was conducted and the results were processed using Bethesda. Results: The average ages were 27.1±4.70 for the pregnant women and 28.8±4.24 for the control group. 60.7% of cases had previously heard of a PAP smear test, 49% were aware of why PAP smear tests were conducted, 26.4% of pregnant participants and 27.3% of non-pregnant participants had previously undergone a smear test. In this study, smear results of all cases were 95.4% sufficient. 18.2% of pregnant cases had an infection, 54.5% had reactive cellular change, and 0.9% had atypical squamous cells of undetermined significance (ASC-US). 16.3% of non-pregnant cases had an infection, 58.1% had reactive cellular change, 3.5% had atypical squamous cells of undetermined significance (ASC-US), and 1.2% had low-grade squamous intraepithelial lesions (LGSIL). Conclusion: PAP smear test is a good opportunity to identify pre-invasive lesions in early phases of pregnancy.

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“…Since they are often premature, with intrauterine growth restriction and consequent low birth weight, these infants born to mothers with a diagnosis of cervical carcinoma during pregnancy are at high risk of neonatal death. 10,33,[52][53][54][55] The choice of delivery route is based on the type and grade of the lesion. In the presence of precursor lesions for cervical carcinoma, whether of low or high grade, vaginal delivery is not contraindicated.…”

Section: Delivery Routementioning

confidence: 99%

“…On the contrary, some authors have correlated spontaneous regression of the lesions during the puerperium to the epithelial desquamation that occurs during delivery, associated with an improved immunological response. 10,13,52,53 For cases with microinvasive carcinomas, the vaginal route can be chosen when conization with disease-free surgical margins is performed. 5 However, other studies have indicated that cesarean section is the best approach.…”

Section: Delivery Routementioning

confidence: 99%

Diagnosis and treatment of cervical cancer during pregnancy

et al. 2009

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CONTEXT AND OBJECTIVE: One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies.The aim here was to provide information about the difficulties in diagnosing and managing cervical neoplasia during pregnancy. MATERIALS:A systematic review of the literature was undertaken through the PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO) databases, using the following words: pregnancy, cervical cancer, diagnosis and management. RESULTS:There was a consensus in the literature regarding diagnosis of cervical carcinoma and management of preneoplastic lesions during pregnancy.However, for management of invasive carcinoma, there was great divergence regarding the gestational age taken as the limit for observation rather than immediate treatment. CONCLUSION:All patients with cytological abnormalities should undergo colposcopy, which will indicate and guide biopsy. Conization is reserved for patients with suspected invasion. High-grade lesions should be monitored during pregnancy and reevaluated after delivery. In cases of invasive carcinoma detected up to the 12 th week of pregnancy, patient treatment is prioritized. Regarding diagnoses made during the second trimester, fetal pulmonary maturity can be awaited, and the use of chemotherapy to stabilize the disease until the time of delivery appears to be viable. RESUMOCONTEXTO E OBJETIVO: Um terço dos carcinomas de colo ocorrem no período reprodutivo, sendo que esta é a segunda causa de morte por câncer nessa fase. A freqüência estimada do carcinoma de colo uterino na gravidez é de um caso para cada 1.000 a 5.000 gestações. O objetivo foi informar sobre as dificuldades frente ao diagnóstico e manejo da neoplasia cervical durante a gravidez. MATERIAIS E MÉTODOS:Revisão sistemática da literatura foi realizada no PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO), usando as seguintes palavras: gestação, câncer cervical, diagnóstico e manejo. RESULTADOS:A literatura apresenta consenso quanto ao diagnóstico do carcinoma cervical e a conduta das lesões pré-neoplásicas durante a gestação.No manejo do carcinoma invasor há grande divergência quanto à idade gestacional considerada como limite para a adoção da observação em vez do tratamento imediato.CONCLUSÃO: Toda paciente com citologia alterada deve realizar colposcopia, a qual indicará e a biópsia. A conização é reservada para pacientes com suspeita de invasão. As lesões de alto grau devem ser acompanhadas durante a gestação e reavaliadas após o parto. Em casos de carcinoma invasor em gestantes com até 12 semanas o tratamento da paciente é priorizado. Nos diagnósticos ocorridos no segundo tr...

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Cervical dysplasia in pregnancy: progression versus regression postpartum

Cited by 16 publications

References 0 publications

Screening for cervical cancer during pregnancy

Screening for cervical cancer during pregnancy

Pap Smear Screening Results for Turkish Pregnant Women

Diagnosis and treatment of cervical cancer during pregnancy

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