现代妇产科进展2011，Vol.20Issue(5)：346-349,4.
2341例妊娠妇女宫颈筛查及产后随访
Cervical screenings and follow-up for 2341 pregnant women
邓洪梅 1梁旭东 1赵昀 1崔淑慧 1任丽华 1魏丽惠1
作者信息
摘要
Abstract
Objective : To investigate the HPV infection,outcome of pathology and postpartum natural outcome of cervical neoplasia during pregnancy. Method: During Jan. 2009 to Feh. 2010,2341 deliveries were performed at Peking University People's Hospital. All women accepted cytology test,whose results were abnomal have got the HPV-HC-Ⅱ DNA examinationor colposcopy examination. Postpartum changes in the Pap smear and in a combined cytologlc,histologic and HPV-HC- Ⅱ DNA were evaluated. Results : ( 1) In 2341 samples,60 cytological abnormal cases were found ( 2. 56％ ) , ineluding ASUCS 48/2341 cases ( 2. 05 ％ ) , LSIL 4/2341 cases(0. 17％ ) , HSIL 8/2341 cases ( 0. 34％ ) ; Of the 60 pregnant patients, high-risk HPV DNA was detected in 25 cases( including 18 positive results)and colposcopy examination was performed in 28 cases( including 21 pathology results) ; about the pathology results, CIN were detected in 13/234lcases ( 0. 56％ ) , including CIN Ⅰ 3/2341 ( 0. 13％ ) , CIN Ⅱ 2/2341 (0. 085％ ) ,CIN Ⅲ 8/2341 (0. 34％ ). ( 2) A total of 51 cytological abnormal cases were followed up successfully. In 51 post-partum samples , there were atypical epithelial cells lO cases,including ASUCS 8 cases, LSIL 1 cases, ASC-H1 cases. The majority of cytological lesions showed a tendency to regress post-partum( approximately 80. 4％ ) . There were 13 HPV positive cases during pregnancy in which only 4 cases still showed positive. There was obvious statistical difference of HPV between pregnancy and postpartum. Of the 51 pregnant patients, CIN were found in 11 pregnant women in which 6 postpartum women still showed CIN( CIN Ⅰ 1 case,CIN Ⅱ 1 case,CIN Ⅲ 4 cases). No case of invasive disease developed during the follow-up period.Conclusion : ( 1 ) The majority of cytological lesions showed a tendency to regress post-partum.Pregnancy was associated with an increased risk for HPV infection,which mostly regress postpartum. (2) The expectant procedure for intraepithelial lesions is the most widely chosen and safe due to the possibility of regression in the postpartum period. (3 ) Patients with cervical dysplasia in pregnancy may be followed conservatively with colposcopy and biopsy. Treatment should be taken as soon as possible once post-partum hiopsy still showed CIN.关键词
宫颈上皮内瘤变/妊娠期/产后/人乳头瘤病毒Key words
Cervical squamous intraepiihelial lesion / Pregnancy/ Postpartum / Human papillomavirus分类
医药卫生引用本文复制引用
邓洪梅,梁旭东,赵昀,崔淑慧,任丽华,魏丽惠..2341例妊娠妇女宫颈筛查及产后随访[J].现代妇产科进展,2011,20(5):346-349,4.
