WOMENS-HEALTH Messages for November, 1998: Re: AGCUS during pregnancy

Re: AGCUS during pregnancy

From: William D. McIntosh, MD (anonymous@obgyn.net)
Sun, 1 Nov 1998 10:38:19 -0600 (CST)

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At Sat, 31 Oct 1998, Andrea wrote: >
>I am currently 10 weeks along in my second pregancy. During my first
>pregnancy I had many abnormal paps. After my baby was born I had
>colposcopy and biopsies taken. Diagnosis was moderate cervical
>dysplasia. Had cryosurgery. I've been going in for follow up paps
>every 3 months for the last year. All came back normal, except my last
>one in August which came back AGCUS - NOT ASCUS. I am wondering how
>this could happen? How can I go from having normal paps to AGCUS all
>within a matter of months? I am going to have a colposcopy at my next
>prenatal appt. Can this be done safely during pregnancy? Can AGCUS
>cause problems for me or the baby during pregnancy? What can my doctor
>do about it with me being pregnant? Will she have to wait to treat me
>till after the baby is born? I am only 23 years old and am very
>concerned about this. Is there a chance that AGCUS could mean nothing
>bad? I've read some fairly scarey things about it. Would appreciate any
>information you could give me. Thank you.

A pap smear with Atypical Glandular Cells of Undetermined Signifigance in pregnancy is almost certainly due to the pregnancy itself, and warrants no treatment usually. Usually it is the result of failing to inform the pathologist that the smear was taken from a pregnant woman. AGCUS smears outside of pregnancy are MUCH more concerning, and require a thorough evaluation. They are much more concerning than ASCUS paps, which are generally no big deal.

Colposcopy (which is just the looking part) is safe during pregnancy, though every effort will be made to avoid unnecessary biopsies. If biopsies are necessary, there is a very small risk to the pregnancy that your physician will wish to discuss with you.

Generally, no treatment of preinvasive cervical disease is undertaken during pregnancy. Fortunately, cervical disease progresses so slowly, in those rare cases when it progresses at all, you will have plenty of time to carry your pregnacy to term, allow for a normal post-partum recovery, and still have plenty of time for treatment, if it is even necessary. The other good news is that the extensive cervical remodeling that accompanies pregnancy, delivery, and post-partum will frequently leave no residual disease.

-- William D. McIntosh, MD Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

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