Mode of Delivery Influences the Regression of Abnormal Cervical Cytology

Abstract

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.

Natural History of Squamous Intraepithelial Lesions in Pregnancy and Mode of Delivery

“…This result correlates with findings of other previously conducted studies (11,(16)(17)(18)(19). However, this is in contrast with the results of five other studies (10,13,(20)(21)(22) which showed higher regression rates in women who delivered vaginally.…”

“…The overall regression rates (cytological regression: 40%, histological regression: 30%) in our study population are similar to those reported in previous studies (3,15,23,24). Chung et al reported a total regression rate of 92.9% which is much higher than the one found in our study (10). The small population of both studies is taken into account for such different findings.…”

“…The majority of pregnancies occur between the ages of 18 and 35 years, corresponding to the age range associated with the greatest incidence of HPV infection and following cervical intraepithelial neoplasia (4,9). This increasing trend may also be attributed to cervical cancer screening being an essential part of prenatal care (10).…”

Comparison of Human Papillomavirus Infection and Cervical Cytology in Women Using Copper-Containing and Levonorgestrel-Containing Intrauterine Devices

“…6 Prior studies suggest a role for inflammation in the spontaneous regression of HPV-related cytologic changes. [7][8][9] All IUDs are associated with some level of local cellular and humoral inflammatory reaction of the endometrium. Copper-containing IUDs (Paragard) release ions that increase prostaglandin levels and white blood cells within the uterine and tubal fluids causing chronic inflammation and a spermicidal effect.…”

Zervikale intraepitheliale Neoplasie 3

“…Einige Studien berichten über höhere Remissionsraten bei Spontangeburt im Vergleich zur Sectio caesarea (67 vs. 12%; [19,20]), in anderen konnte kein signifikanter Unterschied festgestellt werden [17,18]. …”