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BIG SKY, MONT. -- Cervical biopsy should be performed selectively in pregnancy because of the heightened risk of bleeding complications, Dr. John Marlow said at an ob.gyn. update sponsored by the Geisinger Health System.
Bearing in mind that invasive cancer in pregnancy is rare, with an incidence of only 1 per 4,000 pregnancies, it's best to observe colposcopic and cytologic low-grade cervical lesions during pregnancy.
Large biopsy is reserved for lesions showing colposcopic evidence of microinvasion, such as abnormal vascular patterns marked by corkscrewing, marked dilation, or increased intercapillary distance. Under these circumstances, a large biopsy is indicated, using a loop electrical excision procedure or cone, to rule out invasive disease requiring immediate treatment, he said.
Cone biopsy in pregnancy should be done in a hospital setting with anesthesia and the capacity for blood transfusion, added Dr. Marlow of George Washington University Washington.
Cone biopsy in pregnancy carries a high complication rate and should be avoided whenever possible. The procedure is associated with up to a 5% transfusion rate and 25%-30% perinatal mortality. ...
Source: HighBeam Research, Colposcopy in pregnancy: generally avoid biopsy. (Observation May be...