Natural history of cervical intraepithelial neoplasia (CIN) during pregnancy

• a study has examined the natural history of cervical intrapepithelial neoplasia during pregnancy
  • patients with histological CIN were followed during pregnancy with colposcopy every 8 weeks and post-partum evaluation was scheduled 3-6 months after delivery
    • women with post-partum histological diagnosis of CIN 2-3 underwent conization
    • to understand the impact of pregnancy on the evolution of CIN, women with CIN 1 discovered during pregnancy were compared to a group of non-pregnant fertile patients with first diagnosis of CIN 1
      • note that the study was relatively small
        • a total of 78 women were included:
          • 36 (46.2%) with CIN 2-3
          • 42 (53.8%) with CIN 1
        • in women with CIN 2-3, no invasion was suspected during pregnancy and at post-partum evaluation, no invasive or microinvasive cancer, and 19 (52.7%) persistent CIN 2-3, and 17 (47.3%) regressions were diagnosed
        • in the group of CIN 1, we recorded six (14.3%) progressions to CIN 2-3, seven (16.6%) persistent CIN 1 and 29 (69%) regressions.
        • the control group of non-pregnant women had a lower regression rate (37/76: 48.7%) in comparison to pregnant women (p=0.03)
    • the study authors concluded that expectant management for CIN 2-3 diagnosed during gestation is safe. When discovered during pregnancy, CIN 1 has a significantly higher tendency to spontaneous regression in comparison to non-pregnant condition

Reference:

• 1) Serati M et al. Natural history of cervical intraepithelial neoplasia during pregnancy. Acta Obstet Gynecol Scand. 2008;87(12):1296-300