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Best Pract Res Clin Obstet Gynaecol. 2016 May;33:33-43. doi: 10.1016/j.bpobgyn.2015.10.009. Epub 2015 Oct 19.

Premalignant disease in the genital tract in pregnancy.

Author information

1
Institute of Cancer Sciences, The University of Manchester, St Mary's Hospital, Manchester, UK.
2
Institute of Cancer Sciences, The University of Manchester, St Mary's Hospital, Manchester, UK. Electronic address: Henry.kitchener@manchester.ac.uk.

Abstract

Cervical intraepithelial neoplasia (CIN) is the most common premalignant disease of the lower genital tract encountered during pregnancy. As in the non-pregnant state, abnormal cytology should be referred for colposcopy. However, the role of colposcopy in pregnant women is to exclude invasive cancer by visual inspection and defer biopsy and definitive treatment until the post-partum period. Colposcopic exclusion of invasive disease is the only absolute indication for conisation in pregnancy. It is now evident that treatment for CIN outside of pregnancy, that involves >15 mm deep excision is associated with an increased risk of preterm delivery. Vulval intraepithelial neoplasia (VIN) and vaginal intraepithelial neoplasia (VaIN) rarely present in women of childbearing age; nevertheless, medical management should be postponed until after delivery, unless symptoms are particularly severe.

KEYWORDS:

Cervical intraepithelial neoplasia (CIN); colposcopy; endometrial hyperplasia; pregnancy; vaginal intraepithelial neoplasia (VaIN); vulval intraepithelial neoplasia (VIN)

PMID:
26597347
DOI:
10.1016/j.bpobgyn.2015.10.009
[Indexed for MEDLINE]

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