ABNORMAL PAPANICOLAOU SMEARS AND COLPOSCOPY IN PREGNANCY - ANTE-PARTUM AND POSTPARTUM FINDINGS

Abnormal Papanicolaou smears and colposcopic findings suggesting human Papilloma virus (HPV) infection and cervical intraepithelial neoplasi a (CIN) may occur during pregnancy. Condylomata acuminata often grow r apidly during pregnancy and may regress spontaneously following delive ry. However, the post-partum outcome of the untreated ante-partum abno rmal cytologic smear and colposcopy has not been defined clearly. Seve nty-three pregnant patients were examined by colposcopy because of gen ital warts and/or abnormal Papanicolaou smears. Cytologic, colposcopic and histologic re-evaluation was conducted after delivery. Only one o f the patients had a normal ante-partum colposcopic examination. This number increased to 15 after delivery. Forty-one patients had normal p ost-partum cytologic smears, but only 13 had normal histology. Abnorma l post-partum cytology was highly predictive of abnormal colposcopy an d histology. In contrast, normal post-partum cytology was not very acc urate in predicting normal colposcopy and histology. It is concluded t hat a few pregnant patients may have partial regression of clinical HP V infection and abnormal cytology and colposcopy after delivery. Howev er, the majority will continue to have abnormal findings 4 months foll owing delivery in spite of normal postpartum cytology and even colposc opy.