Cervical pathologies in pregnancy

Cervical cancer and its preinvasive lesions are the first and second gynecologic malignancy in developing countries. Also in these countries, the pregnancy rate is high. So, cervical pathology is the most common gynecologic malignancy in pregnant women in developing country. When we look at the statistics of developed country, we also see that cervical pathology the first and second gynecologic malignancy in obstetrics practice. Cervical preinvasive and invasive lesions are seen one per 700-2000 pregnancies. Essentially, diagnostic and therapeutic approaches of this disease are similar to non-pregnant women. The key issue is to think possibility of cervical pathology at the management of a pregnant woman and to be aware of necessity of cervical evaluation in pregnancy.
In pregnant women, preinvasive pathologies are mostly asymptomatic and cervical screening programs using vaginal cytology and colposcopy perform their diagnoses. Punch biopsy and leep excision from cervix can be made easily with insignificant complication in pregnant women, especially in first trimester. However, indication of eonization is highly limited, because of the possibility of ominous hemorrhage. Treatment of these lesions may be postponed after the delivery, but at this approach, micro invasive cancer should be eliminated.
With respect to invasive cervical cancer, the firstly there seems to be no prognostic difference between patients treated in pregnancy and non-pregnant patients with the same stage of disease. That is, pregnancy is not effect prognosis of disease. During the first two trimesters the treatment is carried out along the same principles in non-pregnant patients. The patient is treated without respect to the pregnancy. In advanced pregnancy with viable a fetus, Cesarean section is carried out. Afterwards the patient is treated in the same way as a non-pregnant pregnant woman.