Diagnostic conization for cervical neoplasia during pregnancy using the CO2 laser

Cervical conization during pregnancy has been reported as a procedure with a high morbidity, The authors report their experience in triaging pregnant women with abnormal cytopathology by laser CO2 cervical conization, in a re trospective review. Out of a total of 192 pregnant women, cervical conizati on was performed in 24 cases for diagnostic reasons. Indications for the pr ocedure were suspected invasive disease, unsatisfactory follow-up in patien ts with high-grade squamous intraepithelial lesions (SIL), a major discrepa ncy between cytologic and colposcopic results, or suspected glandular disea se. The procedure was performed with the patient under local anesthesia, us ing CO2 laser. Five cases of microinvasive carcinoma and 19 cases of intrae pithelial disease were found. There were negligible complications from the procedure. Intraepithelial relapse was diagnosed in 3 women during a follow -up ranging from 24 to 69 months. Although colposcopy has eliminated the ne ed for routine diagnostic conization during pregnancy, certain patients may need to undergo the procedure. The CO2 laser in experienced hands provides an excellent means of performing it safely and effectively.