Skip to main content Accessibility help
×
Hostname: page-component-f554764f5-rvxtl Total loading time: 0 Render date: 2025-04-17T06:08:14.228Z Has data issue: false hasContentIssue false

Case 4 - A 35-Year-Old with HSIL Cervical Cytology at 10 Weeks

from Section 1 - Antepartum (Early Pregnancy)

Published online by Cambridge University Press:  08 April 2025

Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
Get access

Summary

The management of cervical dysplasia in pregnant individuals focuses on maintaining maternal well-being while considering pregnancy-related factors. Risk-based colposcopy should be performed with an immediate CIN 3+ risk threshold of ≥4% or with other significant high-risk screening results. Testing for HPV is recommended for individuals aged 30 years and older and for postpartum surveillance of abnormal cases in those aged 25 years and older. The impact of financial support on postpartum medical care can influence the necessity of colposcopy during pregnancy. It is important to note that there are specific challenges with performing colposcopy during pregnancy and there needs to be judicious use of ectocervical biopsy. Excisional procedures are reserved for confirmed or likely invasive disease. In cases of cervical cancer, the involvement of specialized medical practitioners is advised. Postpartum management strategies involving colposcopy and expedited loop electrosurgical excision procedures underscore the significance of risk-based evaluations. In summary, the case provides comprehensive insights into managing cervical dysplasia during and after pregnancy, focusing on evidence-based guidelines and multidisciplinary collaboration for optimal outcomes.

Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
, pp. 10 - 12
Publisher: Cambridge University Press
Print publication year: 2025

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Perkins, RB, Guido, RS, Castle, PE, et al., 2019 ASCCP Risk-Based Management Consensus Guidelines Committee. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J Low Genit Tract Dis. 2020;24(2):102.CrossRefGoogle ScholarPubMed
Sood, AK, Sorosky, JI, Mayr, N, et al. Cervical Cancer Diagnosed Shortly after Pregnancy: Prognostic Variables and Delivery Routes. Obstet Gynecol. 2000;95(6 Pt. 1):832838.Google ScholarPubMed
Chen, C, Xu, Y, Huang, W, et al. Natural History of Histologically Confirmed High-Grade Cervical Intraepithelial Neoplasia during Pregnancy: Meta-analysis. BMJ Open. 2021;11:e048055.CrossRefGoogle ScholarPubMed
Hunter, MI, Monk, BJ, Tewari, KS. Cervical Neoplasia in Pregnancy. Part 1: Screening and Management of Preinvasive Disease. Am J Obstet Gynecol. 2008;199(1):39.Google ScholarPubMed
Demarco, M, Egemen, D, Raine-Bennett, TR, et al. A Study of Partial Human Papillomavirus Genotyping in Support of the 2019 ASCCP Risk-Based Management Consensus Guidelines. J Low Genit Tract Dis. 2020;24:144147.Google ScholarPubMed
Egemen, D, Cheung, LC, Chen, X, et al. Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines. J Low Genit Tract Dis. 2020;24:132143.CrossRefGoogle ScholarPubMed
Fader, AN, Alward, EK, Niederhauser, A, et al. Cervical Dysplasia in Pregnancy: A Multi-institutional Evaluation. Am J Obstet Gynecol. 2010;203(2):113.e1.CrossRefGoogle ScholarPubMed
Douligeris, A, Pergialiotis, V, Pappa, K, et al. The Effect of the Delivery Mode on the Evolution of Cervical Intraepithelial Lesions during Pregnancy: A Meta-analysis. J Gynecol Obstet Hum Reprod. 2022;51(10):102462.CrossRefGoogle ScholarPubMed
Wentzensen, N, Massad, LS, Mayeaux, EJ, Jr., et al. Evidence-Based Consensus Recommendations for Colposcopy Practice for Cervical Cancer Prevention in the United States. J Low Genit Tract Dis. 2017;21:230234.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×