Management of abnormal cytology late in pregnancy

1.1. An outline for the management of patients discovered to have abnormal cervicovaginal cytology late in pregnancy is presented. When an abnormal smear is first obtained later than the thirty-fifth to thirty-sixth week of pregnancy and cervical conization is anticipated and technically feasible, conization is delayed until the infant is of term size and the pregnancy has reached 38 to 39 weeks' duration. Cervical conization with frozen section evaluation of the tissue is then performed and when significant pathology is found, immediate cesarean section hysterectomy is performed. In the presence of invasive carcinoma, cesarean section followed by definitive therapy for Stage I cervical carcinoma is carried out.2.2. The management of the patient is predicated upon the degree of cervical disease anticipated on the basis of the cervical spread. A close correlation between cervical cytology and cervical disease was found.3.3. Cesarean section hysterectomy with removal of 2 to 3 cm. of vaginal cuff is advocated at or near term as treatment for those patients diagnosed as having squamous cell carcinoma in situ of the cervix during pregnancy when no further childbearing is desired. When more children are desired, vaginal delivery is allowed.