Natural History of Cervical Intraepithelial Neoplasia During Antepartum and Postpartum Periods in Pregnant Women with High-Risk HPV Positivity and Abnormal Cervical Cytology

Objective:The colposcopic evaluation of the high-risk human papillomavirus positive and abnormal cervical cytological test results from cervix uteri cancer screening tests taken during pregnancy and comparison of the cytological and histopathological results in the antenatal and postpartum periods were aimed. Methods:The study included 32 pregnant women over the age of 25 who had HPV positive and abnormal cytological results in cervix uteri cancer screening tests conducted during routine antenatal follow-ups between 2022-2025.Our study includes cases of women who presented during pregnancy, where HPV and cervicovaginal smear tests were conducted during the initial assessment and whose results showed high-risk HPV positive and/or abnormal cytological changes.Results: Upon examination of the overall results of our study.According to the smear cytology conducted at the 6th month postpartum, the NILM or healing rates were higher in the group without dysplasia compared to the group with dysplasia, 46% versus 11%, and a statistically significant difference was observed between the two groups (p:0.038).When the colposcopic evaluation and biopsy results conducted at the 6th week postpartum were compared with the colposcopic evaluation and biopsy results taken during the antenatal period, it was observed that 9% of all cases progressed, 63% persisted, and 28% regressed.Upon examining the impact of the delivery method on histopathological results and associated rates, it was observed that there were regression rates of 38% in 6 cases in normal spontaneous vaginal delivery and 19% in 3 cases in caesarean delivery, and that the regression rates after normal delivery were significantly high. Conclusion:Based on the results of high-risk HPV positivity and/or abnormal cytological tests conducted during pregnancy, alongside colposcopic evaluation, only conservative approach during pregnancy and a colposcopy and biopsy approach in the postpartum period are readily implementable.