13 weeks pregnant, Abnormal pap, Severe dysplasia

[Saramomofmany]

I am 13 weeks pregnant with our 5th child. My pap came back abnormal. The results say, "High grade squamous intraepithelial lesion (HGSIL) encompassing moderate and severe dysplasia, CIN2-3/CIS". YIKES!! So my midwife wants me to have a colposcopy and if they see anything a biopsy. I'm hesitant to do anything messing with the cervix during pregnancy. She said if I won't do the colposcopy that she wants to at least do another pap 4 months from the date of the abnormal one.

I'm leaning towards the wait and see approach...what can they really do while you are pregnant as far as treatment anyways that wouldn't endanger the baby?? I tried to ask my midwife if there's anything they can do while pregnant, and she said, oh yeah and went on to say about a woman they took the baby by c-section 2 months early and then did a hysterectomy! :

And also on the CIS part of the diagnosis, does it mean I do have cancer? I have tried to look on the internet, but having trouble finding a real answer.

Thanks so much for your time!! Sara

[BeckiCNM]

Hysterectomy....oh, my. :

Get a second opinion. Seriously, if that's what she told you. Did she tell you if you had high-risk HPV? Even if you have high-risk HPV, the majority of even CIN 3 will get better after pregnancy. Most CIN 2 will. Find someone more up to date.

[Saramomofmany]

Originally Posted by BeckiCNM

Did she tell you if you had high-risk HPV?

I asked her at my appointment if they had tested for HPV(because I had read a book about abnormal paps and HPV), and she said that they had NOT tested for HPV, but if I had the colposcopy they would test at that point.

Do you think having the colposcopy(& biopsy?) would be a good step at this point? The clinic is a small town clinic, so I'm not sure if that has anything to do with it or not...and the midwife wouldn't be the one doing the colposcopy, it would be an OB...

Thanks, Sara

[Saramomofmany]

Originally Posted by BeckiCNM

Even if you have high-risk HPV, the majority of even CIN 3 will get better after pregnancy. Most CIN 2 will. Find someone more up to date.

Becki,

Another question...from what you wrote about the CIN 2 & 3 getting better after pregnancy...does pregnancy cause them to flare up so to speak or make it more likely to have these diagnosis??

Could the diagnosis be wrong??

Thanks, Sara

[junamoss]

Sara,
I had a colposcopy in pregnancy, it was okay. It didn't cause any cervical problems. My ob who did it is someone I trust, and I knew he was being honest with me.
My midwife also urged me to get the colpo.
Good luck,

cindy

[pamamidwife]

please, please PLEASE reconsider doing anything until after the preg - like 10 to 12 weeks after. esp NO BIOPSY. geez.

then take a look at Tori Hudson's book - http://www.amazon.com/Womens-Encyclo.../dp/0879837888

She has an enormous section on cervical dysplasia. she's successfully treated women with non-surgical treatments with minor to moderate dysplasia. she's well respected in the allopathic community here in Oregon.

[mamato3cherubs]

Originally Posted by pamamidwife

please, please PLEASE reconsider doing anything until after the preg - like 10 to 12 weeks after. esp NO BIOPSY. geez.

then take a look at Tori Hudson's book - http://www.amazon.com/Womens-Encyclo.../dp/0879837888

She has an enormous section on cervical dysplasia. she's successfully treated women with non-surgical treatments with minor to moderate dysplasia. she's well respected in the allopathic community here in Oregon.

really really seconding this. NO BIOPSY, oh my goodness, i couldnt even imagine. A colpo itself isnt so invasive, its a take a looksy type deal, but they always want to dig in with the biopsy right there. I would hold off on anything until after the pregnancy, then do a repeat pap and go from there.

[BeckiCNM]

Originally Posted by Saramomofmany

Do you think having the colposcopy(& biopsy?) would be a good step at this point? The clinic is a small town clinic, so I'm not sure if that has anything to do with it or not...and the midwife wouldn't be the one doing the colposcopy, it would be an OB...

CIN 2 and CIN 3 can both get better after pregnancy - the majority will get better. CIN 2 is more likely to get better than CIN 3. I do think pregnancy has an effect on paps. Remember that a pap is just a screening test - it has false positives and false negatives. Sometimes things that look bad on the pap turn out to be OK with the colpo.

The biggest risk is that there is actually invasive cancer in there. (CIN is not invasive cancer - CIN is the step before cancer. The statistics are that it can take years for CIN to turn into cancer). My doc who does my colpos says she can usually tell just by looking if there is invasive cancer. Me - personally - I would do the colpo and only biopsy if there was something that looked like real cancer - not CIN, not just something that looked funny, but only biopsy something that looked like actual cancer. There's a chance you could miss real cancer if it didn't look abnormal enought going this route, but balance the risk of waiting if you actually did have real cancer, and the risk of the biopsy. If they didn't see anything that looked like real cancer, if it were me, I would just have another pap after the baby was born.