natural history of cervical intraepithelial neoplasia (CIN) during pregnancy

Last reviewed 01/2018

  • a study has examined the natural history of cervical intrapepithelial neoplasia during pregnancy
    • patients with histological CIN were followed during pregnancy with colposcopy every 8 weeks and post-partum evaluation was scheduled 3-6 months after delivery
      • women with post-partum histological diagnosis of CIN 2-3 underwent conization
      • to understand the impact of pregnancy on the evolution of CIN, women with CIN 1 discovered during pregnancy were compared to a group of non-pregnant fertile patients with first diagnosis of CIN 1
        • note that the study was relatively small
          • a total of 78 women were included:
            • 36 (46.2%) with CIN 2-3
            • 42 (53.8%) with CIN 1
          • in women with CIN 2-3, no invasion was suspected during pregnancy and at post-partum evaluation, no invasive or microinvasive cancer, and 19 (52.7%) persistent CIN 2-3, and 17 (47.3%) regressions were diagnosed
          • in the group of CIN 1, we recorded six (14.3%) progressions to CIN 2-3, seven (16.6%) persistent CIN 1 and 29 (69%) regressions.
          • the control group of non-pregnant women had a lower regression rate (37/76: 48.7%) in comparison to pregnant women (p=0.03)
      • the study authors concluded that expectant management for CIN 2-3 diagnosed during gestation is safe. When discovered during pregnancy, CIN 1 has a significantly higher tendency to spontaneous regression in comparison to non-pregnant condition

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