Conservative Approach in a Patient with Cervical Intraepithelial Neoplasia Type-3 in Pregnancy: Impact on Disease Progression and Pregnancy Outcome

摘要

Treatment strategy of Cervical Intraepithelial Neoplasia-3 (CIN 3) in background of High Grade Squamous Intraepithelial Lesion(HSIL) is very different amongst the pregnant and non-pregnant women. This case report highlights the approach of diagnosis andmanagement of CIN 3 in pregnancy. A 32-year-old woman, Fourth Gravida one Live issue and previous 2 Abortion (G4P1021),was diagnosed to have cervical intra-epithelial neoplasia (CIN 3) in pregnancy at 20+1 weeks period of gestation. The decision tocontinue pregnancy was made. She was followed with LBC and colposcopy 12 weekly during the pregnancy. Her pregnancy wasuneventful. She delivered vaginally a live born girl, 2.74 kg at 38+4 weeks. In the postpartum period repeat, Liquid Based Cytology(LBC) and colposcopy-directed biopsy were done. The LBC revealed HSIL while biopsy was suggestive of CIN 3. Cone biopsywas done and histopathology report revealed CIN 3 with margins and tips of cone free of tumour. Thus, in this patient neitherprogression nor regression was noted with conservative approach and defnitive management was deferred until the post-partumperiod. The aim of this article is to highlight the approach of diagnosis and management of CIN 3 in pregnancy.