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Pregnancy does not seem to increase the progression of
abnormal cervical cell changes. The presence of abnormal cervical cell changes
or HPV does not affect the outcome of the pregnancy. Close monitoring is needed
so that you and your health professional can make the best treatment decisions
at each stage of the pregnancy.
abnormal Pap test may be evaluated further with
colposcopy. Colposcopy is a safe test during
If colposcopy shows normal tissue, then a repeat Pap
test or colposcopy may be done later, depending on the type of abnormalities
reported on the first Pap test.
If colposcopy confirms abnormal
tissue areas, a
cervical biopsy may be done to diagnose the abnormal
tissue. This level of testing is also done to make sure
cervical cancer, which is rare, is not present. If a
cervical biopsy is needed during pregnancy, it does not usually cause problems
with the pregnancy though the risk of bleeding is greater after the first
trimester. Minor cell changes should continue to be
monitored during the pregnancy and after delivery. Many
minor cell changes return to normal after delivery.
severe cell changes shown on an abnormal Pap test are always evaluated by
colposcopy, and possibly cervical biopsy, to diagnose the abnormal tissue and
to make sure invasive cervical cancer is not present. Follow-up Pap tests and
colposcopy may be done for the rest of the pregnancy to monitor the progression
of the cell changes. Moderate to severe changes can be monitored closely, and
treatment can wait until after delivery. In rare cases a procedure called
a cone biopsy is needed to rule out cancer.
Treatment of invasive
cervical cancer must be done as soon as possible. It is harder to
manage because of the concern for the outcome of both the woman and her
pregnancy. Treatment will be managed by a team of health professionals
specializing in cancer and high-risk pregnancies.
December 28, 2010
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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