Intraepithelial lesions of the uterine cervix during pregnancy: reaffirming the safety of conservative management

Objectives: Diagnosis of high-grade squamous intraepithelial lesions (HGSIL) during pregnancy is not uncommon, and managing these cases presents clinical challenges. In this study we evaluated the safety and outcomes of conservative management for high-grade squamous intraepithelial lesions (HGSIL)...

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Main Authors: Meirovitz Mihai, Pasternak Maya, Kessous Roy, Davidesko Sharon
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925001171
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Summary:Objectives: Diagnosis of high-grade squamous intraepithelial lesions (HGSIL) during pregnancy is not uncommon, and managing these cases presents clinical challenges. In this study we evaluated the safety and outcomes of conservative management for high-grade squamous intraepithelial lesions (HGSIL) diagnosed during pregnancy. Methods: A retrospective case series was conducted at Soroka University Medical Center (2011–2020) including pregnant women with histologically confirmed HGSIL managed conservatively during pregnancy and treated postpartum. Results: Thirty-two women were included. The mean age at diagnosis was 31.2 ± 3.4 years, with most diagnosed in the first trimester (mean gestational age 8.1 ± 4.1 weeks). The average gestational age at delivery was 39.3 ± 1.0 weeks, and mean birth weight was 3045.6 ± 501.7 g. Postpartum conization showed complete regression in 15.6 %, regression to LGSIL in 6.3 %, and persistent HGSIL in 78.1 %. No cases progressed to invasive cancer. During 5.7 ± 2.9 years of follow-up, three patients (9.4%) experienced recurrence requiring repeat conization. Conclusions: Conservative management of HGSIL during pregnancy appears to be a safe and effective approach. In our case series, no progression to malignancy was observed, and postpartum outcomes were favourable. Deferring excisional treatment until after delivery is supported by these findings.
ISSN:2352-5789