Diagnostic et prise en charge des lésions précancéreuses du col utérin pendant la grossesse

High‐grade cervical neoplasia during pregnancy: diagnosis, management and postpartum findings

“…A CIN 2–3 prevalence rate of 0.48% was observed in this study during pregnancy, similar to what has been reported by other authors (2,3,9,19). The lesion evolution during the puerperium, as based on rates of persistence, progression or regression of the lesions, varies among series.…”

“…Although there is consensus on the diagnosis, evolution and treatment of high‐grade squamous intraepithelial lesions (HGSIL) in non‐pregnant women (1), this is not the case in pregnancy. The prevalence of cervical intraepithelial neoplasia (CIN) during pregnancy is as high as 1% (2,3).…”

“…The colposcopically guided biopsy shows a correlation of 73–90% with the final histopathological diagnosis. Few complications occur during pregnancy (0.5–8%) (2–4,9–11). However, Hunter et al (5) report on the disagreement concerning the performance of biopsies during pregnancy.…”

“…In recent years, conservative approaches for providing treatment for high‐grade lesions during pregnancy have been preferred so as to prevent possible complications arising from methods such as conizations (3). In this respect, it has been reported that cold‐knife conization or the loop electrosurgical excision procedure (LEEP) may account for 7.8–33% of complications such as infection, hemorrhage, abortion and preterm delivery (12).…”

Recommandations de la Société française d’urologie gynécologique, de la Société française de chirurgie pelvienne et du Collège national des gynécologues et obstétriciens français sur la prise en charge des cancers invasifs du col utérin pendant la grossesse

“…Un référentiel a été élaboré au sein du CNGOF (disponible à partir de décembre 2008) concernant la prise en charge des lésions préinvasives et dans lequel la prise en charge des patientes en pergravidique a été abordée [1]. Ce chapitre ne concernera donc que la prise en charge des tumeurs invasives.…”