Reliability of colposcopy during pregnancy

Andrea Ciavattini, Matteo Serri, Jacopo Di Giuseppe, Carlo A Liverani, Maria G Fallani, Dimitrios Tsiroglou, Maria Papiccio, Giovanni Delli Carpini, Annalisa Pieralli, Nicolò Clemente, Francesco Sopracordevole

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Abstract

OBJECTIVE: To investigate the reliability of colposcopy during pregnancy and to evaluate the concordance between colposcopic patterns and histopathological findings in these women.

STUDY DESIGN: Multicenter observational study of women diagnosed with an abnormal cervical cytology, who subsequently underwent a colposcopic evaluation with cervical biopsy during pregnancy. The "colpo-histopathological concordance‿ was evaluated. The "colposcopic overestimation and underestimation‿ were evaluated as well.

RESULTS: 69 women, fulfilling the study inclusion/exclusion criteria, constituted the study cohort. Among them, on colposcopic examination, 14 women (20.3%) showed "grade I abnormal colposcopic findings‿, 52 (75.4%) showed "grade II abnormal colposcopic findings‿ and the remaining 3 women (4.3%) had a "suspicious for invasion‿ colposcopy. The histopathological diagnosis showed 2 negative biopsies, 12 (17.4%) cases of CIN1, 50 (72.5%) cases of CIN2 and 5 (7.2%) cases of invasive cervical cancer. We found a colposcopic overestimation in 10 cases (14.5%), underestimation in 12 cases (17.4%), and a concordance in 47 cases (68.1%). A better reliability of colposcopy in women in the firsts two trimesters and in particular in women ≤20 weeks pregnant was found (Cohen's weighted kappa: 0.65).

CONCLUSIONS: When performed by gynecologists with expertise, colposcopy is a reliable diagnostic tool, even during pregnancy. Whenever possible, a colposcopic evaluation during the first half of pregnancy is preferable.

Original languageEnglish
Pages (from-to)76-81
Number of pages6
JournalEuropean Journal of Obstetrics, Gynecology and Reproductive Biology
Volume229
DOIs
Publication statusPublished - Oct 2018

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Ciavattini, A., Serri, M., Di Giuseppe, J., Liverani, C. A., Fallani, M. G., Tsiroglou, D., Papiccio, M., Delli Carpini, G., Pieralli, A., Clemente, N., & Sopracordevole, F. (2018). Reliability of colposcopy during pregnancy. European Journal of Obstetrics, Gynecology and Reproductive Biology, 229, 76-81. https://doi.org/10.1016/j.ejogrb.2018.07.029