Abstract
Objective : To evaluate conservative management for cervical intraepithelial neoplasia (CIN) during pregnancy.
Study Design : seventy-six pregnant women who were diagnosed as having abnormal cervical cytology from 2004 to 2010 were enrolled. All of them underwent colposcopy, followed by prenatal management using cervical cytology every 3 months. Cervical lesions were reevaluated with colposcopy at 2 months postpartum.
Results : The median age was 31 years (20-42), smoking rate was 8/41 (20%). Punch biopsies were performed in 38 of 76 (50%) cases and 11, 14, and 12 cases were diagnosed as having CIN1, CIN2, and CIN3, respectively. Postpartum lesion regression, persistence, and progression were observed in 26/71 (37%), 38/71 (53%), and 7/71 (10%) cases, respectively. There was a statistically significant difference between the mode of delivery and postpartum lesion regression (p=0.014), but no significant difference was seen between smoking and postpartum lesion persistence (p=0.30). Discrepancies between cytology and biopsy were observed in 5/38 (13%) cases.
Conclusions : Although it is valid to manage CIN prenatally during pregnancy, there were some discrepancies between cytology and biopsy. Aggressive colposcopic work-up for these findings can accurately confirm conservative management. Postpartum follow-up was crucial due to lesion persistence.
