Wa. Nahhas et al., ABNORMAL PAPANICOLAOU SMEARS AND COLPOSCOPY IN PREGNANCY - ANTE-PARTUM AND POSTPARTUM FINDINGS, International journal of gynecological cancer, 3(4), 1993, pp. 239-244
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.