Challenges and opportunities in managing pregnant patients with abnormal cervical cytology and positive HPV result in Poland: a single-center retrospective analysis.
The study examined the natural progression of squamous intraepithelial lesions (SIL) and human papilloma virus (HPV) infection during pregnancy, comparing initial and postpartum results. It also assessed delivery mode's impact on outcomes and strategies to improve follow-up care for women with abnormal cervical cancer screening results.
This retrospective study analyzed data from 59 pregnant women with SIL/positive HPV, assessing variables such as cytology, HPV status, and delivery mode. Statistical tests included Wilcoxon rank-sum and Fisher's exact tests.
The average age of patients was 29 years. Over 50% were primigravidas. A significant reduction in abnormal cytology was observed postpartum (89.83% vs. 62.50%, p = 0.009), with an increase in normal results (10.17% vs. 37.50%). No significant differences were found in HPV status (88.89% vs. 81.25%, p =0.655). Colposcopy findings were stable for 76.32% of patients between Visits 1 and 2, with 50% stability between Visits 2 and 3. Postpartum, 30.43% showed regression, while 8.70% showed progression (p = 0.017, padj < 0.050). Higher regression rates were observed after vaginal birth compared to the cesarean section (45.45% vs. 15.38%, p = 0.182) but no significant differences were found (p = 1.000). Almost 60% of patients were lost to postpartum follow-up.
Further studies with a larger population of Polish patients are needed. Cervical cancer screening should be optimized and integrated into a national registry. Pregnant patients with abnormal screening results should be managed by experts, and strategies to enhance patient compliance must be implemented.
This retrospective study analyzed data from 59 pregnant women with SIL/positive HPV, assessing variables such as cytology, HPV status, and delivery mode. Statistical tests included Wilcoxon rank-sum and Fisher's exact tests.
The average age of patients was 29 years. Over 50% were primigravidas. A significant reduction in abnormal cytology was observed postpartum (89.83% vs. 62.50%, p = 0.009), with an increase in normal results (10.17% vs. 37.50%). No significant differences were found in HPV status (88.89% vs. 81.25%, p =0.655). Colposcopy findings were stable for 76.32% of patients between Visits 1 and 2, with 50% stability between Visits 2 and 3. Postpartum, 30.43% showed regression, while 8.70% showed progression (p = 0.017, padj < 0.050). Higher regression rates were observed after vaginal birth compared to the cesarean section (45.45% vs. 15.38%, p = 0.182) but no significant differences were found (p = 1.000). Almost 60% of patients were lost to postpartum follow-up.
Further studies with a larger population of Polish patients are needed. Cervical cancer screening should be optimized and integrated into a national registry. Pregnant patients with abnormal screening results should be managed by experts, and strategies to enhance patient compliance must be implemented.
Authors
Trojnarska Trojnarska, Wielgus Wielgus, Górnisiewicz Górnisiewicz, Kot Kot, Jach Jach
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