Treatment for high-grade cervical dysplasia during pregnancy
Dear OncoLink "Ask The Experts,"
I am 25 years old and I had a pap smear done this year but shortly after became pregnant. About six weeks later I received a call advising me that my pap smear was abnormal with severe dysplasia and a colposcopy was recommended. I was told by a midwife that due to my pregnancy she would not perform any kind of biopsies and she would only examine me with the microscope. Now my question is what kind of treatments can be done while I am pregnant and will this risk my baby's life? Has this happened to other women in a similar situation? I would appreciate if you could answer my questions.
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
While in most cases it is no problem to defer biopsy until after pregnancy (especially in the case of low grade lesions), in the case of high-grade dysplasia, the need for immediate evaluation may warrant biopsy during pregnancy. Experienced coloposcopists routinely biopsy pregnant women safely when the pap smear and colposcopy findings are concerning for a high-grade lesion, though they usually avoid performing an endocervical curettage, which is a scraping from the inside of the cervix. Specific recommendations for treatment and follow up could be made after a definite diagnosis is made on biopsy. I would recommend that you see a gynecologic oncologist or a gynecologist experienced in colposcopy for another