Management of abnormal papanicolaou smears in pregnancy

All pregnant patients with abnormal cervical cytologic smears were evaluated as outpatients in the colposcopy clinic. Of the 131 patients, 84% had colposcopically directed biopsies. Initial biopsy diagnosis of severe dysplasia/ carcinoma in situ was noted in 16% of patients with class II smears and 43% of patients with class III smears. Two patients underwent conization and 2 had modified conizations because they failed to meet our criteria for adequate colposcopic evaluation. Of the 110 patients available for postpartum follow-up, all had either the same or a lesser degree of cervical intraepithelial neoplasia. Invasive carcinoma was not detected in any patient who underwent subsequent hysterectomy or conization. No abortions or premature labors could be directly attributed to the procedure.