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Re: CIN 3 in pregnancyFrom: Braun, R. Daniel (rbraun@iupui.edu)Thu Aug 26 13:57:06 1999
Follow her during the pregnancy, let her deliver, and then repeat her cytology at 3 months postpartum. She may well be cured by the delivery. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN 46202 International Representative for United States OBGYN.net -----Original Message----- From: mstmy@tm.net.my [mailto:mstmy@tm.net.my] Sent: Thursday, August 26, 1999 7:59 AM To: Multiple recipients of list OB-GYN-L Subject: CIN 3 in pregnancy I have a 37 years old patient Para 1 whose pap smear showed mild dyskaryosis. A colposcopy showed some acetowhite areas and a cervical biopsy was performed. Diathermy of the area was also performed in the same sitting. The biopsy result came back as CIN3. Unfortunately she is found to be 12 weeks pregnant. Any comments about the situation? My plan now is to do colposcopic surveilliance during her pregnancy making sure that there is no invasive features and then offer her LLETZ post delivery. Questions 1) Does anybody agree with above? 2) Assuming that she is not pregnant, does anybody think that diathermy is an adequate treatment? I would have thought that it may not be adequate as you may not be sure of the depth of the lesion you destroy and even the extent of it with the concept of field change. Therefore excision method such as LLETZ would be more appropriate follow up treatment I presume. Any comments? 3) Finally any place for less extensive treatment for CIN 3 other than the commonly offered LLETZ or Cone biopsy?
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