Reliability of colposcopy during pregnancy. (October 2018)

• Record Type: Journal Article
• Authors: Ciavattini, Andrea; Serri, Matteo; Di Giuseppe, Jacopo; Liverani, Carlo A.; Fallani, Maria G.; Tsiroglou, Dimitrios; Papiccio, Maria; Delli Carpini, Giovanni; Pieralli, Annalisa; Clemente, Nicolò; Sopracordevole, Francesco
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 229(2018)
• Page Start: 76
• Page End: 81
• Publication Date: 2018-10
• Subjects: SCC squamocellular cervical cancer -- CIN cervical intraepithelial neoplasia -- IFCPC International Federation for Cervical Pathology and Colposcopy -- HIV Human Immunodeficiency Virus -- HSIL High-grade Squamous Intraepithelial Lesion -- ASC-H atypical squamous cells, cannot rule out high-grade lesion -- ASC-US atypical squamous cells of undetermined significance -- LSIL low-grade squamous intraepithelial lesion -- SD standard deviation -- FIGO International Federation of Gynecology and Obstetrics -- ANTZG1 grade I abnormal colposcopic findings -- ANTZG2 grade II abnormal colposcopic findings; Colposcopy -- Pregnancy -- CIN -- Cervical intraepithelial lesions; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2018.07.029
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Objective: To investigate the reliability of colposcopy during pregnancy and to evaluate the concordance between colposcopic patterns and histopathological findings in these women. Study design: Multicenter observational study of women diagnosed with an abnormal cervical cytology, who subsequently underwent a colposcopic evaluation with cervical biopsy during pregnancy. The " colpo-histopathological concordance ‿ was evaluated. The " colposcopic overestimation and underestimation ‿ were evaluated as well. Results: 69 women, fulfilling the study inclusion/exclusion criteria, constituted the study cohort. Among them, on colposcopic examination, 14 women (20.3%) showed " grade I abnormal colposcopic findings‿, 52 (75.4%) showed " grade II abnormal colposcopic findings ‿ and the remaining 3 women (4.3%) had a " suspicious for invasion ‿ colposcopy. The histopathological diagnosis showed 2 negative biopsies, 12 (17.4%) cases of CIN1, 50 (72.5%) cases of CIN2 and 5 (7.2%) cases of invasive cervical cancer. We found a colposcopic overestimation in 10 cases (14.5%), underestimation in 12 cases (17.4%), and a concordance in 47 cases (68.1%). A better reliability of colposcopy in women in the firsts two trimesters and in particular in women ≤20 weeks pregnant was found (Cohen's weighted kappa: 0.65). Conclusions: When performed by gynecologists with expertise, colposcopy is a reliable diagnostic tool, even during pregnancy. Whenever possible, a colposcopic evaluation during the first half of pregnancy is preferable.