Ask An Expert: Abnormal Cells and Pregnancy

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Ask An Expert: Abnormal Cells and Pregnancy

Question:

During pregnancy, what can be done to remove abnormal cervical cells?

Answer:

Pap smears detect abnormal cervical growth associated with human papilloma virus infection; left untreated, this has the potential to develop into cervical cancer. An abnormal Pap smear prompts a more thorough evaluation of the cervix to define the extent and severity of the growth. A colposcopy exam uses a magnifying scope to visually inspect the cervix. Lesions detected on colposcopy are biopsied and assessed by microscope.

An abnormal cervical growth is called dysplasia or cervical intraepithelial neoplasia and can be graded from I to III. The lower grades often get better on their own and can be watched closely without treatment. Higher-grade lesions and persistent low-grade lesions are treated. Treatment is most often performed by surgically removing a larg piece of the cervix including the abnormal cells. This procedure is called cone biopsy.

Pap smears and colposcopy can be safely performed during pregnancy. Small biopsies of the outer part of the cervix are also safe, but the increased cervical blood supply that normally occurs in pregnancy slightly increases the risk of bleeding. Every effort is made to avoid doing a biopsy of the cervical canal and a cone biopsy during pregnancy since these procedures may cause infection, bleeding and preterm labor. Patients are followed very closely with colposcopy exams every three months during pregnancy. However, if testing suggests an advanced or progressive cervical growth, then cone biopsy may have to be performed during pregnancy despite the risk.

Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

Last updated:	May 02, 2007