Review

Abnormal cytologic findings during pregnancy

Michail Georgios, Androutsopoulos Georgios, Georgantis Apostolos, Adonakis Georgios, Decavalas Georgios

Department of Obstetrics and Gynecology, University of Patras, Medical School, Patras, Greece

Correspondence: Michail Georgios, Department of Obstetrics and Gynecology, University of Patras, Medical School, Patras, Greece, E – mail: gr.michail@yahoo.com


Abstract

Our aim was the illustration of the controversies that occur during pregnancy related to the mode of obtaining and interpreting a cervical smear, specific colposcopic features, as well as the approach of diagnosing, following- up and treatment, based on the findings of the Papanicolaou smear. A review of the literature as well as the updated American Society of Colposcopy and Cervical Pathology (ASCCP) guidelines on the management of abnormal Papanicolaou smears known as 2012 Bethesda Consensus Guidelines, was undertaken. The results of the abnormal smears were categorized according to their severity and the current evidence-based diagnostic and therapeutic management has been overviewed. The diagnostic and therapeutic workup is outlined based on the available guidelines to be followed according to the cytology results, the trimester of the pregnancy, and the scheduled mode of the delivery. The interpretation of abnormal cytology smears during pregnancy is similar to those outside pregnancy. However, the effect of the pregnancy in cytology and colposcopy might hamper the discrimination of normal and abnormal epithelium. The arising issues following an abnormal smear are numerous, both from the patient’s and the doctor’s side. The knowledge of optimal cytology management during pregnancy is essential to avoid cases of under- or overtreatment.

Keywords: cervical cancer, pregnancy, cytology, colposcopy

p. 39-48