Carcinoma in situ of the uterine cervix in pregnancy

Objective : The purpose of this study was to determine whether carcinoma in situ (CIS) of the uterine cervix in pregnancy alters in the postpartum period and to evaluate the factors associated with this alteration. Methods : In this retrospective study, we found 30 pregnant women with CIS of the uterine cervix between 1999 and 2003. All women had the diagnosis of CIS made on cervical biopsy performed during pregnancy at Samsung Cheil Hospital. All pathologic reports of initial cytology and biopsy were reviewed and compared to the same evaluations postpartum. Postpartum alteration of CIS was analyzed with respect to the mode of delivery, gravidity and parity. Results : The incidence of CIS in pregnancy was 0.6 per 1000 pregnancies (30/44,807) in this study. The mean age was 31.2 years (20-40), the mean gravidity was 2.7 (1-6) and the mean parity was 0.3 (0-2). The prenatal cytology that initiated the referral to our colposcopy center was commonly discordant with the histologic diagnosis of CIS. Five (16.7%) had cytology of ASCUS, 3 (10.0%) had LSIL, and 22 (73.3%) had HSIL. The overall postpartum persistence and regression rates of CIS were 73.3% and 26.7% respectively. No lesion progressed to invasive carcinoma. There was no statistically difference in regression or persistence rates according to the delivery mode, gravidity and parity. Conclusion : According to the result of this study, postpartum persistence rate of CIS was high but progression rate was low. The mode of delivery, gravidity and parity did not influence the regression or persistence rates of CIS in pregnancy.