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MRCOG PART 2 SBAs and EMQs

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MCQs on Colposcopy/Cervical screening in pregnancy

MCQs on Colposcopy/Cervical screening in pregnancy Posted by ixi C.

 

Dear Paul/Farrukh, 
Question: The following are indications for cervical smear / colposcopy during pregnancy
 
Recent treatment for CIN2 which was completely excised
   True    False Your answer: False Correct answer: True
 
Recent treatment for cGIN which was completely excised
   True    False Your answer: False Correct answer: True


The guidelines state that:

  • Unless there is an obstetric contraindication, assessment should not be delayed if a first follow up cytology or colposcopy is required following treatment for cGIN, or treatment for CIN 2/3 with involved or uncertain margin status.

Does this mean that colposcopy can be deferred in cases of CIN2/3 that have been "completely excised"?

Thank you for your help!
Colposcopy Posted by Farrukh G.

See notes on colposcopy

 

Colposcopy in pregnancy

  • A woman who meets the criteria for colposcopy should have it even if she is pregnant.
  • The aim is to exclude invasive disease and to defer biopsy or treatment until the woman has delivered.
  • Women seen in early pregnancy may require a further assessment in the late second trimester at the clinician’s discretion.
  • If CIN 1 or less is suspected, colposcopy should be repeated three months following delivery
  • If CIN 2 or 3 is suspected, colposcopy should be repeated at the end of the second trimester or, if the pregnancy has already advanced beyond that point, three months following delivery
  • If invasive disease is suspected clinically or colposcopically, a biopsy is recommended. Cone, wedge and diathermy loop biopsies should be taken where appropriate facilities to deal with haemorrhage are available. Punch biopsy suggesting only CIN cannot reliably exclude invasion.
Posted by ixi C.

Thank you! =)