Introduction/Background To determine the correlation between cytologic abnormalities, colposcopic and histologic findings in pregnant women.
Methodology Retrospective unicentric study of 117 patients with cytologic abnormalities detected during pregnancy at Hospital 12 de Octubre (Madrid, Spain) between 2009–2019.
Results The mean age at diagnosis was 32,5 years (±5,8), 4,3% were immunocompromised and 19,8% were smokers. 2,6% of the patients had delivered three times or more. Only 3,6% of the patients had been vaccinated against HPV before diagnosis. Pap test was performed during first trimester in 57.3% of the patients. The most common cervical cytologic abnormality LSIL in 34,2% of the patients. 85.5% of the study population underwent a colposcopy. Among the patients with lesser cytological abnormalities (ASC-US/LSIL), 77,2% of them presented none or minor colposcopic findings. In the group of those with major cytological abnormalities (HSIL/ASC-H), 35,1% of them presented major colposcopic findings. Degree of agreement (Kappa=0.129).
In 41,9% cases of major colposcopic findings: HSIL in 76,9% and LSIL in 23,1% was found. In 18,8% cases of minor colposcopic findings, a colposcopy-guided biopsy was considered, and the histopathological diagnosis showed 6,3% cases negative, 12,5% of LSIL, 25% others, and 56,3% of HSIL. Degree of agreement (Kappa=0.198).
Conclusion Considering minor cytological abnormalities, we found a better agreement between cytology and minor colposcopic findings, however, not so many grade II colposcopic findings were found when patients with major cytological abnormalities underwent colposcopy. Our data suggest a possible overestimate in pregnant women with major cytological abnormalities.
We found a low concordance between colposcopy and anatomopathological results regarding in cases with minor colposcopic changes; that up to 56,3% had a definitive HSIL result in the biopsy. So it is also important that we should take into account the biopsy as a helpful tool to detect malignancy in this challenging population and thus avoiding underdiagnosis.
Disclosure Nothing to disclose.
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