Abstract

OPPORTUNISTIC CERVICAL CANCER SCREENING IN PREGNANCY

Author(s):Radha Bai Prabhu T, Damodara Velayudham , Swati Nethaji, Harshita singhal, Ramya venkatachalam

Introduction: Cervical cancer is the most common malignancy diagnosed during pregnancy. In developing countries where organized screening programmes are lacking, antenatal clinics may provide an opportunity for screening. Objectives: The aim of this study was to analyse the prevalence and management of abnormal cervical cytology in pregnancy. Methodology: This was a prospective study conducted at the Meenakshi Medical College and RI, Kancheepuram, India, from July 2013 to June 2014. Convenience sampling technique was used. After adequate counselling, 300 antenatal mothers between 12 and 34 weeks of gestation were screened with conventional Pap smear. Colposcopy directed biopsy was taken where and when necessary. Results: Among the 300 pregnant women, 90 (30%) were primigravidae and 210 (70%) were multigravidae. 80% were between 21 and 30 years of age. 290 (96.6%) women have never had a pap smear in the past. Conventional Pap smear was taken at < 12 weeks of gestation in 56% of cases, between 13-20 weeks of gestation in 24% of cases, > 21 weeks of gestation in 20% of cases. ASCUS , LSIL and HSIL were reported in one case each. In those with LSIL and HSIL , Colposcopy directed biopsy was reported as CIN 1 and CIN 2 respectively. These two cases were kept under observation during the antenatal period. The CIN II lesion persisted on postpartum follow up and was treated with LLETZ. Conclusion: In countries like India Pap smear screening during pregnancy is worthwhile and the antenatal clinics provide ample opportunities for the screening.

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