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1 results

  • Chapter 3 - Cervical Abnormalities in Pregnancy

  • Edited by Swati Jha, Sheffield Teaching Hospital NHS Foundation Trust, Priya Madhuvrata, Sheffield Teaching Hospital NHS Foundation Trust
  • Book:
    Gynaecology for the Obstetrician
    Published online:
    14 July 2023
    Print publication:
    03 August 2023, pp 23-30

  • Summary

    Conservative management of high-grade pre-invasive disease of the cervix (CIN2–3 ) during pregnancy is acceptable. However, persistent high-risk HPV infection is a major risk factor for CIN2+ persistence. Close follow-up with HPV testing, and antenatal and post-partum colposcopic evaluation including directed biopsies are necessary. However, women who have undergone excisional treatment for CIN2 and above have an increased risk of preterm delivery and preterm rupture of membranes (PROM). Smoking is an important impact factor that could change the vaginal environment influencing the viral load. Treated patients should be informed about increased risk of preterm births and clinicians should offer the most appropriate treatment to optimise the chances of a healthy pregnancy without compromising women’s treatment options. In women diagnosed with invasive cervical cancer in pregnancy, the option of neoadjuvant chemotherapy (NACT) as a means of reaching fetal maturity versus termination followed by definitive management should be offered to the patient.