COMPUTERIZED COLPOSCOPY AND CONSERVATIVE MANAGEMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA IN PREGNANCY

Background. Computerized colposcopy is the noninvasive digital process ing of colposcopic images acquired using a charge-coupled device camer a. The purpose of this study was to evaluate the clinical applications of computerized colposcopy, and to record the colposcopic changes ass ociated with progression or regression of cervical intraepithelial neo plasia in pregnancy. Methods. Forty-one pregnant patients, with abnorm al Papanicolaou smears and a fully visualized squamo-columnar junction , were serially monitored throughout their pregnancies using computeri zed colposcopy. All patients had baseline computer-assisted measuremen ts of their cervical lesions and a repeat measurement at monthly inter vals and at 3-months postpartum. Results. During the period of gestati on, 17.1% of lesions increased in size, 21.9% remained unchanged, 41.5 % decreased in size and 19.5% disappeared completely. In patients with an increase in lesion size, a colposcopically directed punch biopsy w as performed which revealed CIN III but no microinvasion. Cervical bio psy during pregnancy was unnecessary in 82.9% of cases. Conclusion. Th e ability to sequentially monitor and quantify colposcopically visuali zed lesions, using computerized colposcopy, provides a noninvasive obj ective mode to evaluate progression, stability, or regression of CIN l esions during pregnancy.