Disorders of the Cervix and Characteristics of Colposcopy in Pregnant Women

Abstract

Study Objective: To determine the frequency of disorders of the cervix and identify characteristics of colposcopy specific to pregnant women infected with the human papillomavirus (HPV). Study Design: This was an open-label, non-interventional, comparative, cohort clinical study. Materials and Methods: Three hundred and thirty pregnant women participated in the study. They were divided into four groups: Group I (n = 73) was made up of women without any disorders of the cervix and with a negative test for human papillomavirus (HPV); Group II (n = 75) consisted of women with disorders of the cervix who did not have HPV; Group III (n = 96) comprised those who did not have disorders of the cervix, but had HPV; and Group IV (n = 86) consisted of patients with disorders of the cervix and HPV. Examinations performed included HPV testing with serotyping, cervical cytology (Pap smear), and colposcopy. Study Results: HPV was detected in 55.2% of the patients (182/330), 44.5% of whom (81/182) had types 16/18 HPV. The prevalence of grades I and II disorders of the cervix (mild and moderate) in women who had HPV as well as disorders of the cervix was 17.5% (15/86) according to colposcopy data and 9.3% (8/86) detected by cytology (р = 0.06). The total frequency of these disorders, irrespective of HPV status, was 9.3% (15/161) and 5.6% (9/161), respectively (р = 0.29). Interpretation of the colposcopy data in pregnant women was difficult in some cases due to changes in the cervix, which explains the 3.7% discrepancy between colposcopy and cytology in detecting disorders of the cervix. Conclusion: HPV screening may be done first in pregnant women, followed by cytology in HPV-positive patients. Colposcopy may be reserved for women with high-grade squamous intraepithelial lesions to exclude invasive cancer. Keywords: pregnancy, human papillomavirus, disorders of the cervix, risk factors, colposcopy.