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Diagnostic Conization for Cervical Neoplasia During Pregnancy Using the CO 2 Laser

1999; Mary Ann Liebert, Inc.; Volume: 15; Issue: 4 Linguagem: Inglês

10.1089/gyn.1999.15.197

1557-7724

Emmanuel Diakomanolis, Alexandros Rodolakis, Stylianos Michalas,

Cancer Risks and Factors

Cervical conization during pregnancy has been reported as a procedure with a high morbidity. The authors report their experience in triaging pregnant women with abnormal cytopathology by laser CO2 cervical conization, in a retrospective review. Out of a total of 192 pregnant women, cervical conization was performed in 24 cases for diagnostic reasons. Indications for the procedure were suspected invasive disease, unsatisfactory follow-up in patients with high-grade squamous intraepithelial lesions (SIL), a major discrepancy between cytologic and colposcopic results, or suspected glandular disease. The procedure was performed with the patient under local anesthesia, using CO2 laser. Five cases of microinvasive carcinoma and 19 cases of intraepithelial disease were found. There were negligible complications from the procedure. Intraepithelial relapse was diagnosed in 3 women during a follow-up ranging from 24 to 69 months. Although colposcopy has eliminated the need for routine diagnostic conization during pregnancy, certain patients may need to undergo the procedure. The CO2 laser in experienced hands provides an excellent means of performing it safely and effectively. (J GYNECOL SURG 15:197, 1999)