[Conisation and pregnancy (author's transl)]

Abstract

Reference is made to experience obtained from specialised outpatient practice in an account of diagnostic and therapeutic approach to pregnant women with pathological cervix smear. Six out of 93 pregnant women were conisised during pregnancy and 41 after delivery. Postpartum primary vaginal hysterectomy was performed on three women with additional gynaecological indication. Strict follow-up checks were made on 43 patients, among them three with residual dysplasia who had undergone conisation prior to conception. Differentiated approach, which is of great practical importance, in particular to high-risk pregnancy, has proved to be possible by specialised diagnosis, with colposcopy, differential cytological testing, and microbiopsy being included. Postponement of conisation to a date after delivery or after achievement of the desired family size can be justified under the condition of regular follow-up checks for women with intra-epithelial cervical neoplasia, on account of the latter's long latency. However, immediate therapeutic action, even within pregnancy, must be the response to any indication to invasive growth.