Opportunities of Interferon Therapy in Pregnant Women with Cervical Intraepithelial Neoplasia

Abstract

Due to hormonal and immune response changes, pregnancy contributes to their adverse stimulating effect on the progress of already existing hyperplastic processes in the cervix. The resulting aggravation of severity in their clinical course and intensity of the pathological process relatively frequently leads to precancerous conditions and cervical cancer developing further on. Some authors note the upward trend in the number of pregnant women having been diagnosed with pre-cancer and cancer of the cervix, as women postpone their maternity decisions increasingly more often. Currently, the tactics of managing pregnant women with cervical dysplasia consists in dynamic observation, including cytological study, colposcopic assessment of the state of surface cervical epithelium taking into account physiological particularities which are characteristic of pregnancy. The use of interferon therapy in pregnant female patients with HPV-associated cervical neoplasia is also expedient owing to its positive effect for reducing the CIN progression frequency, the probability of infecting the fetus with human papillomavirus, and the frequency of perinatal complications. Methods: The study involved pregnant women in their second and third trimesters of gestation who have been diagnosed with cervical neoplasia (L-SIL, H-SIL). In comparison groups, behavior of cervical neoplasia was monitored against the background of the therapy conducted with interferon alpha-2b or without treatment. Results: Against the background of the therapy conducted with interferon alpha-2b drug, higher frequency of the pathological process improving and lower frequency of its progressing into more severe dysplasia forms have been registered in the pregnant women with HPV-associated cervical neoplasia. However, it must be noted that efficiency of the treatment is higher in the group of pregnant women with L-SIL than in the H-SIL female patients. Conclusion:In managing the CIN pregnant women, it is expedient to prescribe interferon therapy systemically and topically in the form of gel (Viferon®) which allows reducing inflammation, viral load, ensuring regression of L-SIL and stabilization of H-SIL.