COLPOSCOPY AND DIRECTED BIOPSY RELIABILITY DURING PREGNANCY - A COHORT STUDY

The reliability of cytology, colposcopy, and directed biopsy were asse ssed in pregnancy and compared with that observed in a matched non-pre gnant control group in order to evaluate the influence of pregnancy. O ne hundred and seventeen gravidas in which the final pathology could b e ascertained and 234 control patients were examined by the same colpo scopist. Concordance between cytology and final diagnosis was complete or within one degree of severity in 55.6% and 77.8% of patients, resp ectively. Unsatisfactory colposcopy was significantly less frequent in pregnant patients than in controls (12.8% vs. 23.1%, P = 0.023). In p regnant patients, colposcopy provided concordance, overestimation and underestimation of the final diagnosis in 72.6%, 17.6% and 9.8%, respe ctively. In the same group, the concordance between the histologic fin dings of directed biopsy and final diagnosis was complete or within on e degree of severity in 83.7% and 95.9%, respectively. The reliability of cytology, colposcopy and directed biopsy was not related to pregna ncy. These data show that the physiological changes which occur in pre gnancy do not significantly alter the reliability of colposcopy and di rected biopsy, if the colposcopist is aware of the peculiar difficulti es and does not overreact to the accentuated patterns that may occur d uring pregnancy.