Risk Factors for Progression or Persistence of Squamous Intraepithelial Lesions Diagnosed During Pregnancy

Abstract

Age of the patient older than 25 years, HSILs, and HPV type 16 infection are risk factors for the progression or persistence of intraepithelial lesions of the cervix in the postpartum period.

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

“…According to our study, the mode of delivery did not significantly influence the natural history of cervical precancerous lesions in the study population. 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.…”

Colposcopically directed cervical biopsy during pregnancy; minor surgical and obstetrical complications and high rates of persistence and regression

“…The lesions of these 163 women showed persistence, regression and progression in 55, 33 and 12%, respectively (Figure 1). In the subgroup of 55 women in whom colposcopically directed loop-biopsies (n = 46; gestational week 11-27) or LEEP-cones (n = 9; gestational week [12][13][14][15][16][17][18][19][20][21][22] were performed due to suspicion of micro-invasive cancer, the persistence, regression and progression rates were 32, 66 and 1%, respectively. In the subgroup of women with LGL during pregnancy (n = 29), none of the cases progressed, 59% regressed to normal and 41% persisted as LGL.…”

“…However, considerably lower progression rates of dysplasia during pregnancy than that of the present study have been reported. In one study, a USA population (13), albeit with questionable methodology since the results was entirely based on cytology, and a Spanish population (14), which to a large extent relied on cytology, progression rates of between 3 and 4% were reported. This further indicates that the large differences in reported rates of dysplasia progression during pregnancy may be due to different definitions of progression.…”

Cervical Intraepithelial Neoplasia 2, 3 in Pregnancy

“…Many studies reported that, in pregnant patients younger than 25 years, there is practically no progression to invasion [12, 22,23]; however, in women older than 25 years, progression to cervical cancer has been reported in 2% to 14.2% [15,16,19,23]. Many studies reported that, in pregnant patients younger than 25 years, there is practically no progression to invasion [12, 22,23]; however, in women older than 25 years, progression to cervical cancer has been reported in 2% to 14.2% [15,16,19,23].…”