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med:abnormal_cervical_cytology_in_pregnancy [2018/03/15 00:45] – [Punch Biopsy] V_Lmed:abnormal_cervical_cytology_in_pregnancy [2024/04/24 08:38] (현재) – 172.68.119.58
줄 6: 줄 6:
 Pregnant women — The evaluation and management of pregnant women is different from non-pregnant women because of the risk that trauma to the cervix could lead to preterm labor or delivery. Pregnant women — The evaluation and management of pregnant women is different from non-pregnant women because of the risk that trauma to the cervix could lead to preterm labor or delivery.
  
-===PAP===+=====PAP=====
 |ASC-US | 분만 후 재검| |ASC-US | 분만 후 재검|
 |LSIL |분만 후 재검 (Acceptable) 혹은 분만전 확대경 (Preferred)  and/or 조직검사((CIN 2 or 3 혹은 암 의심시))| |LSIL |분만 후 재검 (Acceptable) 혹은 분만전 확대경 (Preferred)  and/or 조직검사((CIN 2 or 3 혹은 암 의심시))|
줄 12: 줄 12:
  
   *  The rate of CIN 2,3 is only 3.7 percent on postpartum follow-up for women with prenatal ASC-US or LSIL.    *  The rate of CIN 2,3 is only 3.7 percent on postpartum follow-up for women with prenatal ASC-US or LSIL. 
 +====ASC-US====
 +Pregnant women with ASC-US and a positive HPV test may elect to have [[colposcopy]] during pregnancy or wait until at least six weeks after delivering their baby. 
  
-===Punch Biopsy===+The reason for this recommendation is that cervix appears somewhat different during pregnancy, which can make it difficult to determine if an area appears abnormal due to pregnancy or due to precancerous changes. In addition, most mild abnormalities resolve over time without treatment. 
 + 
 +====ASC-H==== 
 + 
 +Pregnant women with ASC-H should have a colposcopy. This is because ASC-H is more likely than ASC-US to be caused by a precancerous change. Management after colposcopy depends upon the result of the biopsy (see below). 
 + 
 +5 year cancer rate 2% 
 + 
 +CIN3+ risk is between LGSIL and HGSIL 
 + 
 + 
 +====LSIL==== 
 + 
 +Colposcopy is recommended for pregnant women with LSIL, similar to non-pregnant women. Management after colposcopy depends upon what the biopsy shows. 
 + 
 +=====Punch Biopsy=====
 |CIN I|분만 후 재검| |CIN I|분만 후 재검|
 |CIN II,III|3-4개월 간격 확대경 & PAP| |CIN II,III|3-4개월 간격 확대경 & PAP|
줄 33: 줄 50:
 junction may become visible. junction may become visible.
  
-If CIN 3 or carcinoma is suspected, biopsy is recommended.+=====확대경검사===== 
 +CIN 3 이나 암이 의심되는 경우에는 조직검사를 시행한다((If CIN 3 or carcinoma is suspected, biopsy is recommended)) 
 +임신 중 조직검사는 해롭지 않다는 증거가 있다. 
  
-There is evidence that biopsy in pregnancy is not harmful.+고등급이형성증이 있는 산모는 반드시 경험 있는 부인과의사가 진료하도록 한다.
  
-Women with high-grade dysplasia in pregnancy should be +저등급(LSIL)이나 ASC-US 인 경우 3개월 후에 세포검사를 다시 시행한다. 
-seen by an experienced colposcopist.+
  
- 
-Women with an ASC-US or LSIL test result during 
-pregnancy should have repeat cytology testing at 
-3 months post pregnancy. (III-B) 
  
 Pregnant women with HSIL, ASC-H, or Pregnant women with HSIL, ASC-H, or
줄 53: 줄 67:
  
  
-=====ASC-US===== 
-Pregnant women with ASC-US and a positive HPV test may elect to have [[colposcopy]] during pregnancy or wait until at least six weeks after delivering their baby.  
  
-The reason for this recommendation is that cervix appears somewhat different during pregnancy, which can make it difficult to determine if an area appears abnormal due to pregnancy or due to precancerous changes. In addition, most mild abnormalities resolve over time without treatment. 
  
-=====ASC-H===== 
- 
-Pregnant women with ASC-H should have a colposcopy. This is because ASC-H is more likely than ASC-US to be caused by a precancerous change. Management after colposcopy depends upon the result of the biopsy (see below). 
- 
-5 year cancer rate 2% 
- 
-CIN3+ risk is between LGSIL and HGSIL 
- 
- 
- 
- 
-=====LSIL===== 
- 
-Colposcopy is recommended for pregnant women with LSIL, similar to non-pregnant women. Management after colposcopy depends upon what the biopsy shows.