Effect of delivery route on natural history of cervical dysplasia

Kaneshiro, Bliss; Acoba, Jared D.; Holzman, Jennifer; Wachi, K M; Carney, Michael E.

doi:10.1016/j.ajog.2004.12.078

Cited by 21 publications

(16 citation statements)

References 4 publications

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“…Similar findings with respect to impact of mode of delivery on regression rates were also published by Kaneshiro et al 10 …”

Section: Natural History Of Cervical Dysplasia In Pregnancysupporting

confidence: 87%

“…[6][7][8] Whether the mode of delivery (vaginal birth vs. cesarean section) is associated with regression rate remains controversial. 3,6,[8][9][10] Two publications reported reduction in cervical cancer risk with cesarean delivery, whereas other studies found higher regression rate with vaginal delivery or no difference with respect to mode of delivery at all. Ahdoot et al 8 published a series of 138 pregnant women with antepartum abnormal cervical cytology and their postpartum Papanicolaou smear with respect to mode of delivery.…”

Section: Natural History Of Cervical Dysplasia In Pregnancymentioning

confidence: 94%

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Abnormal Pap Smear and Cervical Cancer in Pregnancy

Yang¹

2012

Clinical Obstetrics &Amp; Gynecology

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Pregnancy represents a unique opportunity to screen reproductive age women for cervical cancer and abnormal cervical cytology is relatively common in this population. In the absence of large, prospective clinical trials investigating the optimal management strategies for cervical dysplasia in pregnant women, consensus guidelines established by the American Society for Colposcopy and Cervical Pathology is available with considerations to this special patient population. Modalities for evaluation and management algorithms are reviewed and summarized from largely case series of pregnant women with cervical dysplasia and cervical cancer.

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“…Similar findings with respect to impact of mode of delivery on regression rates were also published by Kaneshiro et al 10 …”

Section: Natural History Of Cervical Dysplasia In Pregnancysupporting

confidence: 87%

Section: Natural History Of Cervical Dysplasia In Pregnancymentioning

confidence: 94%

Abnormal Pap Smear and Cervical Cancer in Pregnancy

Yang¹

2012

Clinical Obstetrics &Amp; Gynecology

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“…Previous studies identified higher regression rates of HPV-related lesions among women who delivered vaginally compared to those who had Caesarean sections [43,44], in contrast to other studies, which found similar regression rates for women who had vaginal or c-section deliveries [45,46]. Ours is the first study to assess HPV clearance in the context of different modes of delivery, but our findings did not make evident any significant difference between them respecting HPV clearance.…”

Section: Discussionmentioning

confidence: 83%

HPV clearance in postpartum period of HIV-positive and negative women: a prospective follow-up study

et al. 2013

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BackgroundHPV persistence is a key determinant of cervical carcinogenesis. The influence of postpartum on HPV clearance has been debated. This study aimed to assess HPV clearance in later pregnancy and postpartum among HIV-positive and negative women.MethodsWe conducted a follow-up study with 151 HPV-positive women coinfected with HIV, in 2007–2010. After baseline assessment, all women were retested for HPV infection using PCR in later pregnancy and after delivery. Multivariable logistic regressions assessed the putative association of covariates with HPV status in between each one of the successive visits.ResultsSeventy-one women (47%) have eliminated HPV between the baseline visit and their second or third visits. HIV-positive women took a significantly longer time (7.0 ± 3.8 months) to clear HPV, compared to those not infected by HIV (5.9 ± 3.0 months). HPV clearance was significantly more likely to take place after delivery than during pregnancy (84.5% x 15.5%).ConclusionsBoth HIV-positive and negative women presented a significant reduction in HPV infection during the postpartum period. HIV-positive status was found to be associated with a longer period of time to clear HPV infection in pregnant women.

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“…The number of pregnant women presenting with abnormal cervical cytology has increased to approximately 5% of all pregnancies [1,2,3]. This increasing trend may be attributed to cervical cancer screening becoming an essential component of prenatal care as well as to the fact that the peak incidence of cervical intraepithelial neoplasia (CIN) and childbirth coincide within the third decade of life [4,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Vlahos et al [10] had explained their high regression rate of CIN with traumatic alterations of the cervical epithelium occurring at the time of delivery and rapid postpartum healing which may have led to an altered epithelial architecture secondary to surface repair of ulcerated, lacerated, or bruised tissues. Also, as in the study of Kaneshiro et al [3], cervical trauma and immunologic responses after vaginal delivery are assumed to result in regression of dysplastic lesions in postpartum patients. While the incidence of CIN in pregnant women is the same as that of nonpregnant women [2,5,11,12], Serati et al [13] in their study on the evolution of CIN in pregnant women presented that the spontaneous regression rate of CIN 1 was higher in pregnant compared to non-pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Mode of Delivery Influences the Regression of Abnormal Cervical Cytology

Chung

Son

Nam

et al. 2011

Gynecol Obstet Invest

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Aims: The purpose was to investigate the influence of delivery mode on the postpartum regression of abnormal cervical cytology. Methods: A retrospective review was conducted of 64 pregnant women with abnormal cervical cytology at Yonsei University Health System in Korea between 2001 and 2008. A Papanicolaou smear and pathological data were categorized into three groups by cervical intraepithelial neoplasia classification. Postpartum evaluation was taken 3–6 months after delivery. The regression rates of cervical cytologic findings were compared between the vaginal delivery group and Cesarean section group. p < 0.05 was considered significant. Results: Of the 64 women, 45 (70.3%) were delivered vaginally and 19 (29.7%) by cesarean section. No significant difference was found between the two groups with respect to age, gestational age, parity, smoking, and HPV (human papilloma virus) screening. Postpartum regression was shown in 39 (92.9%) women who delivered vaginally and in 12 (63.2%) women who underwent cesarean section (p = 0.016). In the cesarean section group, 1 patient had progressed from CIN2 to microinvasive cancer and 2 patients from carcinoma in situ to invasive cancer. Conclusion: The rate of spontaneous regression of antepartum abnormal cervical cytology was higher after vaginal delivery.

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Effect of delivery route on natural history of cervical dysplasia

Cited by 21 publications

References 4 publications

Abnormal Pap Smear and Cervical Cancer in Pregnancy

Abnormal Pap Smear and Cervical Cancer in Pregnancy

HPV clearance in postpartum period of HIV-positive and negative women: a prospective follow-up study

Mode of Delivery Influences the Regression of Abnormal Cervical Cytology

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