Objective: To study the cytopathologic characteristics of cervical diseases in pregnant women and the outcomes of the postpartum women to provide evidence for prevention and treatment of cervical cancer.
Methods: This study was conducted among 2329 pregnant women undergoing routine gestational examinations between September, 2012 and September, 2013. The women with abnormal cytological findings by Thin-prep cytology test (TCT) were followed up and colposcopy and cervical biopsy were performed. The TCT results of these women were compared with those of 32 491 non-pregnant women in Zhongshan Cervical Cancer Mass Screening Program.
Results: Of the 2329 pregnant women, a total of 97 patients had abnormal TCT results (4.16%). Cervical biopsy were performed for 14 patients (14.43%), and 8 (57.14%) of them had evidence of cervical intraepithelial neoplasia (CIN) or cancer on biopsy. In the 32491 non-pregnant women in the mass screening program, 1383 (4.26%) women had abnormal TCT results and cervical biopsy were performed for 248 patients (17.93%), among whom 148 (59.68%) had evidence of CIN or cancer on biopsy. The rate of high-grade squamous intraepithelial lesion (HSIL) was significantly higher in non-pregnant women than in pregnant women (P=0.033), but the total rate of cytological abnormalities were comparable between them (P=0.911). The patients with CIN had regular examinations during pregnancy and postpartum follow-up showed no invasive carcinoma.
Conclusion: Pregnancy is not a risk factor to accelerate the progress of cervical lesions, and most of the cervical lesions are relieved or show no progression in the postpartum women, suggesting the feasibility of follow-up during pregnancy and postpartum reevaluation for patients with CIN in pregnancy.