Conservative Approach in a Patient with Cervical Intraepithelial Neoplasia Type-3 in Pregnancy: Impact on Disease Progression and Pregnancy Outcome
Published: November 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/37597.12248
Pradip Kumar Saha, Garima Sachdeva, Rashmi Bagga, Jaswinder Kaur Kalra, Pranab Dey
1. Additional Professor, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
2. Junior Resident, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, Delhi, India.
3. Professor, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
4. Professor, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
5. Professor, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
Correspondence
Dr. Pradip Kumar Saha,
Additional Professor, Department of Obstetrics and Gynaecology, Third Floor, Nehru Hospital, PGIMER,
Chandigarh-160012, India.
E-mail: pradiplekha@yahoo.co.in
Treatment strategy of Cervical Intraepithelial Neoplasia-3 (CIN 3) in background of High Grade Squamous Intraepithelial Lesion (HSIL) is very different amongst the pregnant and non-pregnant women. This case report highlights the approach of diagnosis and management of CIN 3 in pregnancy. A 32-year-old woman, Fourth Gravida one Live issue and previous 2 Abortion (G4P1021), was diagnosed to have cervical intra-epithelial neoplasia (CIN 3) in pregnancy at 20+1 weeks period of gestation. The decision to continue pregnancy was made. She was followed with LBC and colposcopy 12 weekly during the pregnancy. Her pregnancy was uneventful. She delivered vaginally a live born girl, 2.74 kg at 38+4 weeks. In the postpartum period repeat, Liquid Based Cytology (LBC) and colposcopy-directed biopsy were done. The LBC revealed HSIL while biopsy was suggestive of CIN 3. Cone biopsy was done and histopathology report revealed CIN 3 with margins and tips of cone free of tumour. Thus, in this patient neither progression nor regression was noted with conservative approach and definitive management was deferred until the post-partum period. The aim of this article is to highlight the approach of diagnosis and management of CIN 3 in pregnancy
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