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| med:abnormal_cervical_cytology_in_pregnancy [2024/04/24 08:34] – [임신 중 비정상 자궁세포검사] 172.70.222.134 | med:abnormal_cervical_cytology_in_pregnancy [2024/04/24 08:38] (현재) – 172.68.119.58 | ||
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| 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) | |LSIL |분만 후 재검 (Acceptable) 혹은 분만전 확대경 (Preferred) | ||
| 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. | ||
| + | |||
| + | 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=== | + | =====Punch Biopsy===== |
| |CIN I|분만 후 재검| | |CIN I|분만 후 재검| | ||
| |CIN II, | |CIN II, | ||
| 줄 33: | 줄 50: | ||
| junction may become visible. | junction may become visible. | ||
| - | ====고등급==== | + | =====확대경검사===== |
| CIN 3 이나 암이 의심되는 경우에는 조직검사를 시행한다((If CIN 3 or carcinoma is suspected, biopsy is recommended)) | 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. | 임신 중 조직검사는 해롭지 않다는 증거가 있다. | ||
| 고등급이형성증이 있는 산모는 반드시 경험 있는 부인과의사가 진료하도록 한다. | 고등급이형성증이 있는 산모는 반드시 경험 있는 부인과의사가 진료하도록 한다. | ||
| - | ====저등급==== | + | |
| 저등급(LSIL)이나 ASC-US 인 경우 3개월 후에 세포검사를 다시 시행한다. | 저등급(LSIL)이나 ASC-US 인 경우 3개월 후에 세포검사를 다시 시행한다. | ||
| 줄 50: | 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. | ||