Cervical screening in pregnant patients

Abstract

To determine the prevalance of cervical lesions of pregnant women in the Turkish population and to contribute to the formation of a national screening program in the general population. Material Method: To determine the relation-ship between pregnancy and cervical cancer cervical smear was obtained from 812 random-ly selected patients who applied to the our maternity clinic. Results: Normal cervical findings were present in (n=212) %26.1 of the patients, whereas %2.46 (n=20)of the patients revealed reactive and repetetive changes, (n=7) %0,086 revealed ASCUS, %0.049 (n=4) had SIL (with HPV findings) and (n=l) % 0.012 had invasive carsinoma of the cervix. Conclusion: The epitelial changes in the gravid cervix and the early diagnosis of inva-sive cervical cancer is possible with PAP smear, which is an effective population screening test.

Keywords

• Vaginal Smears,Pregnancy,Prevalence,Cervix Diseases

Gebelerde servikal smear taraması

Öz

Amaç: Türk toplumunda gebe populasyondaki servikal lezyonlarm sıklığını saptamak, ve genel populasyonda ulusal bir tarama programı oluşmasına katkıda bulunmaktır. Materyal Metod: Zeynep Kamil Kadın ve Çocuk Hastalıkları Hastanesi Kadın Doğum Antenatal polikliniğine başvuran 812 gebe hastaya gebelik serviks kanseri ilişkisini saptamak üzere PAP smear uygulandı. Bulgular: 812 gebeden n=212 (%26.1) inde normal bulgular saptanırken, n= 568 % 69.95'inde enfeksiyon, n=(20) %2.67'sinde reaktif ve repetetif değişiklikler, (n=7) %0.086'sında ASCUS, (n=4) % 0.049 'unda SlL (HPV ile uyumlu ), (n=l) %0.012'sinde ise invazif serviks karsinomu saptandı. Sonuç : Gebelikte serviksteki epitelyal deği siklikler ve invazif serviks kanserinin erken tanısı bir kitle tarama testi olan PAP smear ile mümkündür.

Anahtar Kelimeler

• Vajinal smirler,Gebelik,Yaygınlık,Serviks hastalıkları

Kaynakça

1. 1. Williams SF,Bitran JD:Cancer and preg-nancy.Clin Perinatol 1985;12:609
2. 2. Hacker NF,Berek JS,Lagasse LDxarsinoma of the cervix associated with pregnancy Obstet.Gynecol 1982 ;59:735
3. 3. National Cancer Institude : Cancer Statistics Review 1973-1987.Bethesta,NCL Publication No: (N1H)199O; 90:2789
4. 4. Di-Saia P, Crasman W. Preinvasive disease of the cervix. Clinical Gynecologic Oncology.Fourth ed. Baltimore Williams &Wilkins,1993;l: 10-11
5. 5. Eddy DM: Screening for cervical cancer. Annuals of Internal Medicine 1990;113: 214-226
6. 6. Boutselis JG. Intraepitelial carsinoma of the cervix associated with pregnancy. Obstet Gynecol 1972 ;40: 657-666
7. 7. Kashimura M, Matsuura Y, Shinohara M: Comporative study of cytology and punch biopsy in cervical intraepitelial neoplasia during pregnancy. Acta Cytologica,1991;35:l-5
8. 8. Fowler WC Jr, Walton La, Edelman DA. Cervical intraepitelial neoplasia during preg-nancy.South Med J.1980;73: 1180-1185

9. 9. La Polla JP, O'Neil C, Wetrich D. Colposcopic management of abnormal cervical cytology in pregnancy. J Reprod Med 1988;33: 301-306
10. 10. DePetrillo AD, Townsend DE, Morrow CP, Lickrish GM. Papanicolaou test in pregnancy. Am J Obstet Gynecol 1975;121: 441-445
11. 11. Smith Mr, Figge DC, Bennington JL. The diagnosis of cervical cancer during pregnancy. Obstet Gynecol 1968 ;31: 193-197
12. 12. Wied GL. Epitelial abnormalities on the ectocervix during pregnancy. J Reprod Med 1970;4: 13-73
13. 13. Bozkurt S. Jinekolojik onkolojide servikovaginal sitoloji. Atasu T, Aydınlı K; editors. Jinekolojik Onkoloji. Istanbul: Logos, 1996;12: 182-191
14. 14. Kuquchi K,Bibbo M,Hasegawa T: Displasia during pregnancy:a cytologic follow up studyj Reprod Med 1981; 26:66-70
15. 15. Burghardt E. Histopathology of cervical epitelium. Colposcopy -Cervical pathology textbook and atlas. Second ed. Thieme Sturrgart-New York.l981;3: 32-39
16. 16. Dudkiewicz J, Waksmanski B, Cieslak-Stec M, Korzeniowska-Kumaszka E. (Analysis of clinical usefulness of the cytologic smear results for pregnant women using the Bethesda system) Ginekol Pol 2002;73(4): 314-9
17. 17. Bertini-Oliveira AM, Keppler MM, Luisi A, Tarico S, Lopes VLD, Delascio L Comporative evaluation of abnormal cytology in histopathology in preclinical cervical during pregnancy. Acta Cytol 1982;26: 636-644
18. 18. Sail S,Rini S,Pineda A: Surgical management of invazive carcinoma of the cervix in pregnancy Am j Obstet Gynecol 1974 ;118:1-9
19. 19. Mork BJ,Montz FJ.Invazive cervical cancer complicating intrauterine pregnancy :Treatment with radical hysterectomy.Obstet Gynecol 1992;80:199-205
20. 20. Lutz MH, Underwood PB, Roizer JC. Genital malignancy in pregnancy. Am J Obstet Gynecol 1977;129: 536-40
21. 21. Hoosen AA, Ross SM, Mulla MJ, Patel M. The incidance of selected vaginal infections among pregnant urban blacks. S Afr Med 1981;30 :827-9-14
22. 22. Wilson JD, Robinson Aj, Kinghorn SA, Hicks DA. Implications of inflammatory changes on cervical cytology. Br Med J. 1990;300: 638-640
23. 23. MathewR, KalyaniJ, BibiR, MallikaM. Prevalence of bacterial vaginosis in antenatal women. Indian J Pathol Microbiol 2001 Apr;44(2): 113-6
24. 24. Jimenez Cordera AA, de Alba EGE. Colposcytology pregnancy. Gynecol Obstet Mexico 1995;63: 33-7
25. 25. Malone JM, Sokol RJ, Ager JW. Pregnancy, human papillomavirus and cervical intraepitelial neoplasia. Eur J Gyneacol Oncol 1988;9: 120-4
26. 26. Soost HJ, Lange HJ, Lehmacher W, Ruffing Kullmann B. The validation of cervi-calcytology: sensivity, specivity, and predictive values. Acta Cytol 1991;35: 8-16.