Bakari Fadimatu, Abdul Muhammad A, Ahmed Saad A
Department of Obstetrics and Gynecology, Reproductive Health and General Gynaecology Unit, Faculty of Medicine, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Department of Pathology, Faculty of Medicine, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Ann Afr Med. 2017 Apr-Jun;16(2):74-80. doi: 10.4103/aam.aam_35_16.
In spite of knowledge of the causes and prevention of cervical cancer, screening programs for cervical cancer have not yet been fully implemented in most developing countries including Nigeria. Documented data on the prevalence of preinvasive cervical lesion in pregnancy are scarce in our environment.
To determine the prevalence, risk factors, and course of preinvasive cervical lesion in pregnant women attending an antenatal clinic in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Northern Nigeria Study Design: This was a cross-sectional longitudinal study.
The study was conducted in an antenatal clinic of ABUTH Zaria.
A prospective cross-sectional longitudinal analysis was carried out at an Antenatal Clinic of ABUTH Zaria, Nigeria. A total of 250 consecutive pregnant women who fulfilled the inclusion criteria and have given their consent were recruited into the study at the time of their first prenatal (booking clinic) visit for antenatal care. Data from the pregnant women were obtained using a pro forma to evaluate sociodemographic characteristics and risk factors for preinvasive disease. Conventional Papanicolaou smear was taken using the standard procedure. The cytopathologic findings of initial and postpartum Pap smear were documented in the pro forma. Prevalence, persistence, progression, and regression rates of preinvasive diseases were determined.
Out of the 250 pregnant women who had cervical cytology by Pap smear during the study, 15 had preinvasive cervical lesion, giving a prevalence rate of 6%; 13 (87%) were low-grade squamous intraepithelial lesion (LGSIL) while 2 (13%) were high-grade squamous intraepithelial lesion (HGSIL). Negative smears were seen in 158 women (63.2%). Inflammatory and other conditions of the cervix which are technically negative smears made up the remaining 30.8%. At postpartum follow-up of the 13 women with LGSIL, 2 (15.4%) became negative while persistence of the disease was observed in 9 (69.2%) of the cases. Two women with LGSIL were lost to follow-up. Of the two women with HGSIL, persistence of the disease was seen in one woman (50%) and regression of the disease was seen in the other woman. Risk factors that were found to be associated with preinvasive cervical lesion were age at coitarche <16 years, number of sexual partners since coitarche, and previous history of sexually transmitted infection and human immunodeficiency virus. Parity, smoking, and use of contraception were found not to be significant risk factors.
Preinvasive lesion of the cervix is relatively common among antenatal clients in our center. Antenatal clients with HGSIL should have a repeat smear at the end of the puerperium before treatment. Routine Pap smear should be offered to all antenatal clients in our setting.
尽管了解宫颈癌的病因及预防方法，但包括尼日利亚在内的大多数发展中国家尚未全面实施宫颈癌筛查项目。在我们所处的环境中，关于妊娠期间宫颈浸润前病变患病率的文献资料匮乏。
确定在尼日利亚北部扎里亚市阿哈穆杜·贝洛大学教学医院（ABUTH）产前诊所就诊的孕妇中宫颈浸润前病变的患病率、危险因素及病程。研究设计：这是一项横断面纵向研究。
该研究在ABUTH扎里亚市的产前诊所进行。
在尼日利亚ABUTH扎里亚市的产前诊所进行前瞻性横断面纵向分析。共有250名符合纳入标准并已签署知情同意书的连续孕妇在首次产前（预约诊所）就诊进行产前检查时被纳入研究。通过使用一份表格获取孕妇的数据，以评估社会人口学特征及浸润前疾病的危险因素。采用标准程序进行传统巴氏涂片检查。初始及产后巴氏涂片的细胞病理学检查结果记录在表格中。确定浸润前疾病的患病率、持续率、进展率及消退率。
在研究期间通过巴氏涂片进行宫颈细胞学检查的250名孕妇中，15名有宫颈浸润前病变，患病率为6%；13名（87%）为低级别鳞状上皮内病变（LGSIL），2名（13%）为高级别鳞状上皮内病变（HGSIL）。158名女性（63.2%）涂片结果为阴性。宫颈炎症及其他技术上涂片结果为阴性的情况占其余的30.8%。在对13名LGSIL患者进行产后随访时，2名（15.4%）转为阴性，9名（69.2%）病例疾病持续存在。2名LGSIL患者失访。在2名HGSIL患者中，1名（50%）疾病持续存在，另1名疾病消退。发现与宫颈浸润前病变相关的危险因素为初次性交年龄<16岁、初次性交后性伴侣数量、既往性传播感染及人类免疫缺陷病毒病史。经产妇、吸烟及使用避孕措施未被发现是显著的危险因素。
宫颈浸润前病变在我们中心的产前检查患者中相对常见。患有HGSIL的产前检查患者在产后结束时治疗前应再次进行涂片检查。在我们的环境中，应向所有产前检查患者提供常规巴氏涂片检查。
