Abstract
Objective: To clarify the usefulness of the Bethesda System in cervical cytology during pregnancy.
Study design: Cervical smears were obtained from 3, 369 pregnant women at Tottori University Hospital between 1987 and 1998. Of these, 19 cases whose cytologic specimens were judged as class IIIa or more were entered in this study. Those samples were re-evaluated by the Bethesda System.
Result: According to the Bethesda system, the specimens were classified as follows: Two cases of unsatisfactory for evaluation, 5 cases of infection, 6 cases of low grade squamous intraepithelial lesion (LSIL), 5 cases of high grade SIL (HSIL) and 1 case of invasive cancer. In all cases whose samples were judged to be infection, the cervical lesions disappeared during the follow-up period. In 5 of 6 cases of LSIL, the cervical lesions disappeared. However the lesion did not disappear in the HSIL case. Three of the class IIIa cases which were scored as moderate dysplasia were judged to be HSIL. Of these, 2 cases were carcinoma in situ and 1 was severe dysplasia. In the Bethesda system, when moderate dysplasia is scored, the sample is judged to be HSIL. Therefore, it may be feasible to identify high risk patients from cassical IIIa cases using this system.
Conclusion: The Bethesda system may be useful for cytology during pregnancy.
