Postpartum regression rates of antepartum cervical intraepithelial neoplasia II and III lesions

Objective: To study the histologic regression and progression rates of cerv ical intraepithelial neoplasia (CIN) II and III after delivery and the effe ct the route of delivery has on the regression rates of GIN. Methods: Pregnant patients with satisfactory colposcopic examinations and b iopsy-proven CIN II and III were identified. Delivery information and postp artum biopsy results were obtained by chart review. Results: Two hundred seventy-nine patients had antepartum biopsies of CIN I I or CIN III. Of these, 126 women were excluded for the following reasons: lost to follow-up (75), human immunodeficiency virus positive (two), cesare an hysterectomy (four), and inadequate postpartum follow-up (45). This yiel ded a study group of 153 patients consisting of 82 with CIN II and 71 with CIN III. The regression rates were 68% and 70% among CIN II and CIN III pat ients (P = .78), respectively. Seven percent of patients with CIN II progre ssed to CIN III on postpartum evaluation. Twenty-five percent of those pati ents with CIN II and 30% of those with CIN III remained the same postpartum . No CIN lesions progressed to invasive carcinoma. There were no difference s in regression rates or progression rates among the women who had vaginal deliveries (130), women who labored and then underwent cesarean (17), or wo men who proceeded to a cesarean without laboring (six). Conclusion: We found similar high postpartum regression rates despite the r oute of delivery. We recommend conservative antepartum management with post partum colposcopic evaluation regardless of route of delivery because we ar e unable to predict which of these lesions are more likely to regress. (C) 1999 by The American College of Obstetricians and Gynecologists.