MINIMAL LASER CONIZATION DURING PREGNANCY

The objective of this study was to evaluate a minimal laser conization procedure during pregnancy for safe diagnosis and treatment of carcin oma in situ. This was a clinical prospective study in a University Hos pital. Seventy-five pregnant women selected on the basis of a cervical smear showing carcinoma in situ or dysplasia, or an extensive picture confirmed by colposcopy, were referred for minimal conization procedu re. A free-hand minimal conization procedure using a carbon dioxide (C O2) laser was performed in ambulant care under local anaesthesia. The minimal conization procedure is defined as the removal of a 7.0 mm hig h, slightly conical tissue specimen from the uterine cervix containing the entire transformation zone. After the cone specimen was taken, ro utine cervical curettage was also performed. There were no complicatio ns attributable to the conization procedure and no adverse effects eit her during pregnancy or at delivery. Histopathological examination of the cone specimens from 75 patients revealed carcinoma in situ or dysp lasia in 65 cases. More advanced malignancy was found in 10 cases; mic ro-invasive carcinoma stage 1A (n=7) or stage 1B (n=3). The minimal co nization procedure with CO2 laser during pregnancy enables safe diagno sis of carcinoma in situ selected by cytology and colposcopy. It also proved useful for diagnosis and treatment of stage 1A or stage 1B carc inoma, enabling pregnancy to be preserved and radical cancer treatment to be postponed until delivery.