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Acta Obstet Gynecol Scand. 2013 Jun;92(6):692-9. doi: 10.1111/aogs.12138. Epub 2013 Apr 17.

Colposcopically directed cervical biopsy during pregnancy; minor surgical and obstetrical complications and high rates of persistence and regression.

Author information

  • 1Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. cecilia.karrberg@vgregion.se

Abstract

OBJECTIVE:

To evaluate whether colposcopically directed cervical biopsies during pregnancy are associated with surgical/obstetric complications and to examine the natural course (regression, persistence, progression) of dysplasia during pregnancy.

DESIGN:

Prospective clinical study.

SETTING AND POPULATION:

University Hospital and 251 pregnant women with atypical cervical cytology in early pregnancy.

METHODS:

The patients were investigated by colposcopically directed punch biopsies, colposcopically directed loop-biopsies or LEEP-cones. The histology results during pregnancy were compared with those after delivery to evaluate the natural course of dysplastic lesions during pregnancies. Postoperative complications were recorded. Obstetric outcome was recorded and compared with the 54,919 other births in the same geographical area during the study period.

MAIN OUTCOME MEASURES:

Persistence, regression and progression of cervical dysplasia, surgical complications after diagnostic procedure, incidence of preterm birth, mode of delivery.

RESULTS:

Only a minor part (12.3%) of the dysplastic lesions showed progression during pregnancy, with 54.6 and 33.1% showing persistence and regression, respectively. No surgically related postoperative bleeding that needed surgical (diathermy/suture) treatment occurred and the miscarriage rate was low (0.8%). There were no differences in mode of delivery, preterm birth or other obstetrical variables between the study group and the large control cohort.

CONCLUSION:

Investigation of atypical cytology during pregnancy with biopsy including large loop excisions is a safe procedure with regard to surgical complications and obstetrical outcome. There is a high rate of persistence and regression of dysplasia during pregnancy.

© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

PMID:
23590574
[PubMed - indexed for MEDLINE]
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