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Thread: Lordy, lordy, another issue.
May 15th, 2013 02:33 PM #19
"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).Blade, MD
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