Publication: Postpartum regression rates of antepartum cervical intraepithelial neoplasias
Abstract
Bu çalışmada amaç gebe kadınların antepartum devredeki kontrollerinde tespit edilen anormal servikal sitolojik bulguların, postapartum devrede vajinal ve sezaryen doğumlar sonunda spontan regresyona uğrayıp uğramadığı araştırılmıştır. 1995-1998 seneleri arasında antepartum devrede anormal sitolojik bulguları olan 142 hasta incelendi. Bunlar arasında demografik, sitolojik ve klinik bulguları yeterli 94 hasta araştırmaya alındı. Papanicolaou smear bulguları Bethesda sınıflandırma sistemine göre ''atypical squamous cells of undetermined significance, low-grade squamous intraepithelial lesion, ve high-grade squamous intraepithelial lesion'' olmak üzere 3 dereceye ayrıldı. Antepartum perioddaki anormal servikal sitolojik bulgular vajinal ve sezaryenle doğum yapmış kadınlarda servikal epitel hücre değişiklikleri Papanicolaou smear, kolposkopi ve biyopsi yapılarak araştırıldı. Araştırmaya alınan 94 kadından 70 (%74) i vajinal, 24 (%26) ü sezaryen ile doğum yaptılar. Bu kadınlar arasında yaş, parite ve sigara kullanımı bakımından önemli fark bulunmadı. Antepartum devredeki anormal sitolojik bulgularda, vajinal veya sezaryen ile doğum yapan kadınların postpartum dönemde yapılan sitolojik kontrollerinde her 3 grupta da (ASCUS, LGSIL, HGSIL) istatistiksel anlamlı fark bulunmadı. HGSIL'i olan 39 kadından 28'i vajinal, 11'i sezaryen ile doğum yaptı ve postpartum devrede sırasiyle %68, ve %64 regresyon görüldü. Sonuç olarak antepartum kontrollerinde anormal servikal sitolojileri tespit edilen hastalarda, postpartum devrede önemli derecede spontan regresyon bulundu. Bundan dolayı gebelerde tedavi girişimleri tehir edildi ve direnç gösteren vakaların uygun tedavileri postpartum periyodda yapıldı.
OBJECTIVE: To evaluate whether pregnant women with abnormal antepartum cervical cytologic findings differ in their postpartum rates of regression with respect to mode of delivery. STUDY DESIGN: Between 1995-1998, 142 pregnant women with antepartum abnormal cervical cytologic findings were identified. Complete demographic, clinical and cytologic reports were available for 94 women. Papanicolaou smear data were collected and separated into 3 groups by use of the Bethesda classification system [atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LGSIL), and high-grade squamous intraepithelial lesions (HGSIL)]. Postpartum regression rates of antepartum Papanicolaou smear, with respect to degree of squamous epithelial cell abnormality and mode of delivery were analyzed. RESULTS: Of the 94 women 70 (74%) were delivered vaginally and 24 (26%) by cesarean section. No statistically significant difference was found between women delivered vaginally and those by cesaren section with respect to age, parity, and smoking history within the three groups (ASCUS, LGSIL, HGSIL). Of the 39 women with HGSIL, 28 were delivered vaginally and 11 by cesarean section showed 68%, and 64% regression in the postpartum period, respectively. CONCLUSIONS: Postpartum spontaneous regression of Papanicolaou smears consistent with squamous intraepithelial lesions occur with increased frequency among women who are delivered vaginally or by cesarean section.
OBJECTIVE: To evaluate whether pregnant women with abnormal antepartum cervical cytologic findings differ in their postpartum rates of regression with respect to mode of delivery. STUDY DESIGN: Between 1995-1998, 142 pregnant women with antepartum abnormal cervical cytologic findings were identified. Complete demographic, clinical and cytologic reports were available for 94 women. Papanicolaou smear data were collected and separated into 3 groups by use of the Bethesda classification system [atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LGSIL), and high-grade squamous intraepithelial lesions (HGSIL)]. Postpartum regression rates of antepartum Papanicolaou smear, with respect to degree of squamous epithelial cell abnormality and mode of delivery were analyzed. RESULTS: Of the 94 women 70 (74%) were delivered vaginally and 24 (26%) by cesarean section. No statistically significant difference was found between women delivered vaginally and those by cesaren section with respect to age, parity, and smoking history within the three groups (ASCUS, LGSIL, HGSIL). Of the 39 women with HGSIL, 28 were delivered vaginally and 11 by cesarean section showed 68%, and 64% regression in the postpartum period, respectively. CONCLUSIONS: Postpartum spontaneous regression of Papanicolaou smears consistent with squamous intraepithelial lesions occur with increased frequency among women who are delivered vaginally or by cesarean section.