That's a normal report that you quoted.
Originally Posted by cvdutch31
"Abnormal pap" runs the gamut from ASCUS, low-grade (Atypical Squamous Cells of Undetermined Significance) to CIN (cervical intraepithelial neoplasia) to high-grade dysplasia (bascially, about to become cancer any day now) to full-out cervical cancer.
A colposcopy is just a look-see. Your cervix is painted with vinegar (yes, vinegar-- it was discovered a century ago to light up areas of atypical cytology and works like magic) and punch biopsies can be taken if abnormal areas are seen. The punch biopsies do NOT increase the risk of preterm labor. The punch biopsies get a great deal more tissue than a pap smear (which is a random scraping) and nails down the pathologic diagnosis. From there, you'd be counseled as to whether or not actual excisional treatment is needed.
Excisional treatment-- which is recommended even in pregnancy if the lesion is CIN or higher-- does increase the risk of preterm delivery modestly (odds ratio increases from 1.0 to 1.6 in one series which did not control for the amount of tissue resected-- in another paper where <10mm of cervix was taken, the risk of preterm birth did NOT go up). It's a risk-benefit decision made to balance the health of the mother and pregnancy does NOT impact adequately treating her for cancer or pre-cancerous lesions.
Anyway, see what the pap report shows. If it's ASCUS all you'll need is a colposcopy (which is again just looking, plus or minus very superficial biopsies if an abnormality is seen).
Thank you Blade! I'll come back with the info I get off of the new Pap report. I hate that I even have to think about this right now but it is what it is I guess. It's reassuring to read the info about the "punch biopsies" (YIKES, even reading that makes me cross my legs) not being risky to the baby but my experience with the horrible pelvic infection after the last one has left me scared regardless (interesting semi-relevant side note, the doc who did that procedure shut down her practice a few months later and disappeared off the face of the earth. Odd.). So I'm happy to let her look - but unless she see's something immediately life threatening to myself (or the babe, of course), I'm going to take a temporary pass on the biopsy part. Thank you again! And I just noticed your due date in your signature, mine is 12/8/13. :)
@blade: I feel bad specifically bothering you about this again. I know you probably get tired of medical advice/questions since that's your work... but I am very worried so I'm hoping maybe you can help clear it up? I got the report for the new Pap results today. The first problem is that the doctor used a different lab - so the reports aren't the same and I'm having a hard time comparing them.
But this one says, under "Interpretation: Epithelial Cell Abnormality. Atypical Squamous Cells - of Undetermined Significance." So it is that ASCUS you mentioned. I'm just trying to be sure of what's changed - what I'm thinking is that my first report showed no epithelial cell abnormalities (or intraepithelial?) but my latest report does show it....? I wish they would make a report clearer for us lay-people.
Anyway, thank you again so much for taking the time to offer your thoughts, it's very appreciated!
ASCUS is exactly that-- undetermined significance. It can be caused by anything from infects to a poor sample to actual pre-pre-malignant cells. Since your last pap was normal, you are very very low-risk for cancer, but have the colposcopy to reassure yourself. ASCUS is the least worrisome possible diagnosis.
Hi - I had my first abnormal pap ever with my last pregnancy and did the colposcopy, but no biopsies. Luckily, she didn't see anything that would make her want to - but no problems after and back to a normal pap post delivery. Good luck! I was totally stressed out about it, but it turned out fine. Don't be afraid to stand up for yourself and ask questions - hopefully your doctor will reassure you that she/he is as serious about protecting your cervix (and baby) as you are!
@blade: thank you so much, I needed to hear that reassurance. It's just bugging me so much because I've had nearly 10 years of perfectly normal Paps - now I finally get pregnant, and have SO much to worry about already, and the Pap comes back abnormal TOO?? Come on! But I'm feeling better about it.
@mjc7709: always nice to hear from someone who went thru something similar, thank you for sharing! I will definitely do my best to stand my ground with what I'm comfortable with and what I'm not. She can do the vinegar thing (see Blade's earlier post) and look all she wants, but I don't want to risk another pelvic infection like I got with the last biopsy. So unless it's something that's endangering my life immediately - or the babys - a biopsy can wait. It's just another annoying thing to add to my already-too-long list of worries! But that's life, I know! Thanks again :)