1. social determinats of health research center (SDHRC), Guilan University of Medical Sciences,Rasht,Iran. 2. social determinats of health research center (SDHRC), Guilan University of Medical Sciences,Rasht,Iran 3. social determinats of health research center (SDHRC), Guilan University of Medical Sciences,Rasht,Iran
Abstract
Introduction
Cervical cancer is the most common malignancy diagnosed during pregnancy . the incidence of abnormal pap smear in pregnancy may as high as 5% to 8% .
the aim of this article is increasing health providers' practical information about " cervical cancer in pregnancy "
Methods
this article is provided by reviewing of lectures and internet searching .
Results
Special issues related to managing the abnormal pap smear during pregnancy are summarized as follows :
• refer to expert colposcopist
• manage according to 2001 bethesda guidelines .
• colposcopy hiv- positive women with any ascus .
• colposcopy if oncogenic hpv are present with biopsies .
• do not perform ecc in pregnancy .
• diagnostic cone biopsy only if concerned about invasive cancer ( doing during second trimester )
• do not repeat pap smear less than 6 weeks postpartum .
• unsatisfactory colposcopy may be satisfactory in 6 to 12 weeks or by 20 weeks
• limit biopsy to worse visible area.
• prepare for increased biopsy site bleeding .
• re-evaluate lesion with biopsy if the lesion worsens .
Conclusion
Cervical cancer and dysplasia in pregnancy can be a stressful situation for both the mother and physician . conservative management is the rule , and experts in cervical dysplasia and cancer can help to counsel the pregnant women and carefully follow the lesions , allowing the optimal management for both the mother and the fetus . multidisciplinary team approaches help to maximize both maternal and fetal outcomes .
