Management of severe dysplasia and carcinoma in situ (CIS) during pregnancy

Abstract

During the eight years from 1984 to 1991, 1717 pregnant women were examined using the routine Papanicolaou test. Twenty-six (1.5%) showed abnormal cytologic results. Colposcopically-directed punch biopsies revealed cervical dysplasia and CIS in 14 patients (0.82%). Severe dysplasia and CIS were seen in 8 patients, including an additional 4 referred patients. Different interpretations of cytology and punch biopsy were made in 7 of the 8 cases. Severe glandular involvement of atypical epithelia was observed in 5 cases.
In 6 of the 8 cases, the lesion disappeared after delivery. Overevaluation of the punch biopsy specimens during pregnancy may be the main reason for this change.
The incidence of dysplasia and CIS is the same in pregnant and nonpregnant women, so the routine Papanicolaou test must be performed during pregnancy.