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Old 07-25-2012
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ObGyn HSIL on colpo!

HSIL on pap but colpo is normal..what next ?
A 23-year-old G 1 PO female presents for her first prenatal visit at 14 weeks gestation. A pap smear is done at
that time and a high grade squamous intraepitheliallesions (HSIL) is seen at cytology. A test for HPV
discloses the presence of a strain with high oncogenic risk. A satisfactory colposcopy is done and shows no
site of abnormalities. At this time the next best step is:
A. Loop electrosurgical excision procedure (LEEP)
B. Repeat pap smear 12 months
C. Termination of pregnancy
D. Repeat colposcopy after delivery
E. Endocervical curettage

what if patient not pregnant ?

****please give rationale for the same
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Old 07-25-2012
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Tricky question....
In a Non pregnant woman
Here there is a disparity between pap smear and colposcopy findings....pap smear worse than colposcopy means colposcopy wasnt adequate....next best step is CONE BIOPSY....

In a pregnant woman
Repeat colposcopy after delivery...(MTB 3 page 433 actually says repeat every 3 months till delivery then definitive management by 6-8 wks postpartum )

SO best answer is repeat colposcopy!!....

If it was invasive cancer then this GA would require termination of pregnancy

Last edited by stfidel; 07-25-2012 at 03:07 PM.
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The above post was thanked by:
shyangel18 (07-25-2012), tyagee (07-26-2012)


ObGyn-, Step-2-Questions

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