Abnormal cytology during pregnancy--a retrospective analysis of patients in a dysplasia clinic.

BACKGROUND: The incidence of abnormal cytological results in pregnant women is as much as 7%. Often there is need to advise pregnant women with an abnormal cervical cytology result and monitor them throughout pregnancy, without endangering the mother or child.

PATIENTS AND METHODS: We retrospectively analyzed all pregnant women with an abnormal cervical cytology or condyloma in our dysplasia clinic between 01/2008 and 12/2011. Classification of the cervical cytological results was performed according to the Munich II nomenclature and a biopsy was obtained from most patients. Groups were defined in order to assess regression, persistence and progression. Particular attention was paid to the mode of delivery and the postpartum consultation.

RESULTS: A total of 65 pregnant women were treated in the dysplasia clinic. The reason for referral was Pap IIID in 46.2%, Pap IVa in 40% and Pap III or Pap II with condyloma in 6.2% patients. Only one patient presented with a Pap IVb finding. The pregnancy was continued in all but one cases. Postpartum, a total of 40% of cases, were in remission. A partial remission occurred in 4.6%. Persistence of the abnormalities was observed in 26.2%. Progression was documented in 3% and 71.1% were able to have a vaginal delivery. A caesarean section was performed in 22.2%. A total of 4.4% suffered a miscarriage, which was not caused by the colposcopy.

DISCUSSION: The distinctive feature of the present study is the high number of follow-up examinations, which showed that even women with highly dysplastic changes in pregnancy, who are regularly monitored can be advised to continue pregnancy. Vaginal delivery is possible in most cases.