Abnormal Pap Smear during Pregnancy
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Abnormal Pap Smear during Pregnancy
Oct 2003
I'm 10 weeks pregnant, and just had a pap smear come back that
indicates I may have HSIL. I am also positive for the high
risk version of HPV, so I'm considered high-risk for cervical
cancer. My OB wants to do a colposcopy and possibly a cervical
biopsy. I've read at various sites on the Web that biopsies
during pregnancy aren't a great idea (risk of bleeding seems to
be the biggest problem), and I spoke to a ob/gyn oncologist in
LA who says he NEVER biopsies pregnant women, and always sends
them to an expert colposcopist. Does anyone know of an expert
colposcopist in the bay area? I'm not sure what to do here,
whether to go with my docs decision (which will probably end up
in a biopsy) or try to find someone else up here to go to.
anon
Speak with Karen Smith McCune director at UCSF Health
Care, Dysplasia Clinic 415-885-7878. They deal specifically
with HPV / Dysplasia . You can ask for Dr. McCune, she's
very compasionate and knowledgable. You're in good
hands there. Good Luck ! :)
anon
I too had an abnormal pap during pregnancy. My OB wanted to do
a colposcopy with possible biopsy if she saw something. I asked
her and several obs if this was safe during pregnancy and they
all said it was. I did end up having a biopsy. It was slightly
uncomfortable for a few days, but otherwise, no problems. I had
another pap 3 mo. postpartum and it was normal. The only thing
that was curious to me about the whole thing was that during my
first pregnancy, my ob (a different one) said he didn't do paps
because they frequently were abnormal in pregnant women.
I would definitely get a second opinion from another doctor
before going through with a biopsy. And since you're already at
a higher risk for cancer, it isn't a bad idea to see an OB/GYN
who specializes in high risk pregnancy, and has some experience
in this area. But definitely, yes, get that second opinion!
Karin
Hi. I had a positive colpo for LSIL & HPV prior to getting
pregnant and am in a high risk category due to a history of
breast cancer. When I became pregnant my OB advised not doing
biopsies until after delivery. She felt confident that changes
could be tracked through the high powered viewing with vinegar
to highlight the abnormal cells. As you said, risk of bleeding
is the main worry. There has been, occording to my OB, no
statistical association b/w miscarriage and having a biopsy.
But, I still choose not to have a biopsy, and only have the
colpo viewing. Remember that you are the health care consumer.
From what I have read cervical dysplasia is a slow growing
thing, and there has been no association with pregnancy speeding
up the growth process. Also, it may be just a local bacterial
thing that clears up on it's own. Ask your OB about monitoring
every trimester with the high powered viewing & without biopsy.
If she is very uncomfortable with this idea then seek out advise
of 2+ other OB's prior to making your decision. My OB, prior to
moving to the East Bay, was Dr. Pearlman @ Portola Women's
Clinic. She was awesome, explained everything, called and
talked about my options for 45 minutes @ 8:00pm because she knew
I was going on a long trip and was nervous about the results of
the test.
Remember stress lowers your immune system. Take care of
yourself.
anon
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