Natural history of cervical intraepithelial neoplasia during pregnancy. Export

@article{citeulike:4166357, abstract = {OBJECTIVE: It is uncertain whether pregnancy influences the natural history of cervical intraepithelial neoplasia (CIN). Our aim was to evaluate the evolution of CIN in pregnant women. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology, University of Insubria, Italy. POPULATION: Women with histological CIN during pregnancy. METHODS AND MAIN OUTCOME MEASURES: Between 2003 and 2007, women with an abnormal Pap-smear during pregnancy underwent colposcopy. Patients with histological CIN were followed during pregnancy with colposcopy every 8 weeks and post-partum evaluation was scheduled 3-6 months after delivery. Women with post-partum histological diagnosis of CIN 2-3 underwent conization. To understand the impact of pregnancy on the evolution of CIN, women with CIN 1 discovered during pregnancy were compared to a group of non-pregnant fertile patients with first diagnosis of CIN 1. RESULTS: A total of 78 women were included: 36 (46.2\%) with CIN 2-3 and 42 (53.8\%) with CIN 1. In women with CIN 2-3, no invasion was suspected during pregnancy and at post-partum evaluation, no invasive or microinvasive cancer, and 19 (52.7\%) persistent CIN 2-3, and 17 (47.3\%) regressions were diagnosed. In the group of CIN 1, we recorded six (14.3\%) progressions to CIN 2-3, seven (16.6\%) persistent CIN 1 and 29 (69\%) regressions. The control group of non-pregnant women had a lower regression rate (37/76: 48.7\%) in comparison to pregnant women (p=0.03). CONCLUSIONS: Expectant management for CIN 2-3 diagnosed during gestation is safe. When discovered during pregnancy, CIN 1 has a significantly higher tendency to spontaneous regression in comparison to non-pregnant condition.}, author = {Serati, M. and Uccella, S. and Laterza, R. M. and Salvatore, S. and Beretta, P. and Riva, C. and Bolis, P. F.}, citeulike-article-id = {4166357}, citeulike-linkout-0 = {http://dx.doi.org/10.1080/00016340802482986}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18951206}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18951206}, doi = {10.1080/00016340802482986}, issn = {1600-0412}, journal = {Acta obstetricia et gynecologica Scandinavica}, keywords = {cervicalcancer, pregnancy}, number = {12}, pages = {1296--1300}, posted-at = {2009-03-11 22:11:49}, priority = {3}, title = {Natural history of cervical intraepithelial neoplasia during pregnancy.}, url = {http://dx.doi.org/10.1080/00016340802482986}, volume = {87}, year = {2008} }

TY - JOUR ID - citeulike:4166357 L3 - citeulike-article-id:4166357 N2 - OBJECTIVE: It is uncertain whether pregnancy influences the natural history of cervical intraepithelial neoplasia (CIN). Our aim was to evaluate the evolution of CIN in pregnant women. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology, University of Insubria, Italy. POPULATION: Women with histological CIN during pregnancy. METHODS AND MAIN OUTCOME MEASURES: Between 2003 and 2007, women with an abnormal Pap-smear during pregnancy underwent colposcopy. Patients with histological CIN were followed during pregnancy with colposcopy every 8 weeks and post-partum evaluation was scheduled 3-6 months after delivery. Women with post-partum histological diagnosis of CIN 2-3 underwent conization. To understand the impact of pregnancy on the evolution of CIN, women with CIN 1 discovered during pregnancy were compared to a group of non-pregnant fertile patients with first diagnosis of CIN 1. RESULTS: A total of 78 women were included: 36 (46.2%) with CIN 2-3 and 42 (53.8%) with CIN 1. In women with CIN 2-3, no invasion was suspected during pregnancy and at post-partum evaluation, no invasive or microinvasive cancer, and 19 (52.7%) persistent CIN 2-3, and 17 (47.3%) regressions were diagnosed. In the group of CIN 1, we recorded six (14.3%) progressions to CIN 2-3, seven (16.6%) persistent CIN 1 and 29 (69%) regressions. The control group of non-pregnant women had a lower regression rate (37/76: 48.7%) in comparison to pregnant women (p=0.03). CONCLUSIONS: Expectant management for CIN 2-3 diagnosed during gestation is safe. When discovered during pregnancy, CIN 1 has a significantly higher tendency to spontaneous regression in comparison to non-pregnant condition. IS - 12 JF - Acta obstetricia et gynecologica Scandinavica SN - 1600-0412 EP - 1300 TI - Natural history of cervical intraepithelial neoplasia during pregnancy. VL - 87 SP - 1296 KW - cervicalcancer KW - pregnancy AU - Serati, M AU - Uccella, S AU - Laterza, RM AU - Salvatore, S AU - Beretta, P AU - Riva, C AU - Bolis, PF PY - 2008/// UR - http://dx.doi.org/10.1080/00016340802482986 ER -