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Re: abnormal pap in pregnancyFrom: Robert Brenner (robbrenner@earthlink.net)Sun Oct 12 19:51:31 1997
At 08:56 PM 10/3/97 -0500, you wrote: >On Fri, 3 Oct 1997 12:05:09 -0500, tien@erato.usask.ca (tien le) >wrote: > >>30 yo G2P1 at 34 week gestation with no previous prenatal care. >>Screening PAP showed adenocarcinoma cells X2 all reviewed by good >>cytopathologists. >>Colposcopy and pelvic exam showed no abnormalities with normal cervical >>appearance and consistency. ECC showed poorly differentiated adenoca >>cells. >>Any suggestions for management ? >>She also want to have vaginal delivery if possible. > >Amnio > - if mature, CKC, frozen section > -if invasive, Cesarean rad hyst/nodes > -if equivocal, await permanent, if invasive, as above > -if in situ, margins negative, NSD, hyst in 4-6 wks > > - if immature, wait until 35 to 36 weeks, then plan as above > Craig: The ECC showed Adenocarcinoma not Squamous. And a cold conization at 34 weeks has the potential for a "blood bath". Is there any consideration for doing C-section hysterectomy followed by external radiation if invasive adenocarcinoma is found?
-- Robert Brenner MD FACOG Baltimore MD Robbrenner@earthlink.net
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