Colposcopy and directed biopsy reliability during pregnancy: a cohort study

Baldauf, Jean-Jacques; Dreyfus, Michel; Ritter, J; Philippe, E

doi:10.1016/0301-2115(95)02178-a

Cited by 63 publications

(39 citation statements)

References 18 publications

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“…15,16 Therefore, colposcopy and directed biopsies, when indicated, should be considered for pregnant patients with abnormal cytology and/or suspicious clinical findings.…”

Section: Wwwajogorgmentioning

confidence: 99%

Cervical cancer associated with pregnancy: Results of a multicenter retrospective Korean study (KGOG-1006)

Lee¹,

Lee²,

Kim³

et al. 2008

American Journal of Obstetrics and Gynecology

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“…15,16 Therefore, colposcopy and directed biopsies, when indicated, should be considered for pregnant patients with abnormal cytology and/or suspicious clinical findings.…”

Section: Wwwajogorgmentioning

confidence: 99%

Cervical cancer associated with pregnancy: Results of a multicenter retrospective Korean study (KGOG-1006)

Lee¹,

Lee²,

Kim³

et al. 2008

American Journal of Obstetrics and Gynecology

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“…18 The professional responsible for the colposcopic examination should be experienced in examining pregnant women, because the increased cervical volume, stromal edema and hyperplasia of the glandular epithelium give rise to greater mucus production, and the decidual reaction may impair accomplishment of the examination. 13,19 A vaginal speculum examination or evaluation of the cervix by quadrants may be necessary. It is also important to point out that the increased vascularization of the uterine cervix and the prominent reaction of the metaplastic epithelium to acetic acid may lead to a suspicion of a more severe lesion that is confirmed by histopathological examination.…”

Section: Cytologymentioning

confidence: 99%

“…9 Thus, inspection of the cervix and colposcopy alone are insufficient to distinguish premalignant lesions from invasive lesions, whereas a biopsy directed by colposcopy is the most sensitive method. 9,17,19,20 Biopsy Among pregnant women, the sensitivity and specificity of directed biopsies, in relation to the final diagnosis of the lesion, are 83.7% and 95.9%, respectively. When cervical biopsies are obtained during pregnancy, the risk of bleeding requiring greater accuracy of control is only 1 to 3%.…”

Section: Cytologymentioning

confidence: 99%

“…Occurrences of other complications such as preterm labor and chorionic amniorrhexis are rare. 17,19 Conization is reserved for pregnant women with suspected invasion, since this diagnosis changes the management to be followed during pregnancy in cases in which cytological tests reveal a high-grade lesion and colposcopy is unsatisfactory. However, in most cases, conization is postponed to the postpartum period.…”

Section: Cytologymentioning

confidence: 99%

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Diagnosis and treatment of cervical cancer during pregnancy

et al. 2009

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CONTEXT AND OBJECTIVE: One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies.The aim here was to provide information about the difficulties in diagnosing and managing cervical neoplasia during pregnancy. MATERIALS:A systematic review of the literature was undertaken through the PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO) databases, using the following words: pregnancy, cervical cancer, diagnosis and management. RESULTS:There was a consensus in the literature regarding diagnosis of cervical carcinoma and management of preneoplastic lesions during pregnancy.However, for management of invasive carcinoma, there was great divergence regarding the gestational age taken as the limit for observation rather than immediate treatment. CONCLUSION:All patients with cytological abnormalities should undergo colposcopy, which will indicate and guide biopsy. Conization is reserved for patients with suspected invasion. High-grade lesions should be monitored during pregnancy and reevaluated after delivery. In cases of invasive carcinoma detected up to the 12 th week of pregnancy, patient treatment is prioritized. Regarding diagnoses made during the second trimester, fetal pulmonary maturity can be awaited, and the use of chemotherapy to stabilize the disease until the time of delivery appears to be viable. RESUMOCONTEXTO E OBJETIVO: Um terço dos carcinomas de colo ocorrem no período reprodutivo, sendo que esta é a segunda causa de morte por câncer nessa fase. A freqüência estimada do carcinoma de colo uterino na gravidez é de um caso para cada 1.000 a 5.000 gestações. O objetivo foi informar sobre as dificuldades frente ao diagnóstico e manejo da neoplasia cervical durante a gravidez. MATERIAIS E MÉTODOS:Revisão sistemática da literatura foi realizada no PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO), usando as seguintes palavras: gestação, câncer cervical, diagnóstico e manejo. RESULTADOS:A literatura apresenta consenso quanto ao diagnóstico do carcinoma cervical e a conduta das lesões pré-neoplásicas durante a gestação.No manejo do carcinoma invasor há grande divergência quanto à idade gestacional considerada como limite para a adoção da observação em vez do tratamento imediato.CONCLUSÃO: Toda paciente com citologia alterada deve realizar colposcopia, a qual indicará e a biópsia. A conização é reservada para pacientes com suspeita de invasão. As lesões de alto grau devem ser acompanhadas durante a gestação e reavaliadas após o parto. Em casos de carcinoma invasor em gestantes com até 12 semanas o tratamento da paciente é priorizado. Nos diagnósticos ocorridos no segundo tr...

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“…Toutefois, les mêmes auteurs notent un cas de cancer avec un frottis ASCUS chez une patiente gravide. Mais pour de nombreux auteurs, le frottis présente les mêmes taux de sous-évaluation (20,5 %) ou de surestimation (24 %) qu'avec une population non gravide [14][15][16].…”

Section: Validité De La Cytologieunclassified