Sugai Shunya, Nishijima Koji, Enomoto Takayuki
From the Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan.
Sex Transm Dis. 2021 Jun 1;48(6):403-409. doi: 10.1097/OLQ.0000000000001322.
No clear guidelines are available for the management of pregnant women with condyloma acuminata, a human papillomavirus-associated benign neoplasm that develops in the genital tract. We performed a systematic review to gain a better understanding of the management of condyloma acuminata during pregnancy. In this review, we mainly focused on treatments. We searched PubMed, Google Scholar, and Web of Science to identify studies on the treatment of condyloma acuminata during pregnancy. Thirty articles met the inclusion criteria. The treatment methods described in the literature were laser therapy, cryotherapy, imiquimod, photodynamic therapy, trichloroacetic acid, and local hyperthermia. The most effective treatment remains unclear. Various factors must be considered when deciding how to treat. Based on our assessment of the literature, we recommend cryotherapy as the first-choice treatment and laser therapy as the second-choice treatment. Imiquimod can be considered in cases such as extensive condyloma acuminata that is not easily treated by cryotherapy or laser therapy. In such cases, sufficient informed consent must be obtained from the patient. Cryotherapy, laser therapy, and imiquimod have been administered during all 3 trimesters with no severe adverse effects, but we cautiously recommend reserving laser therapy until the third trimester because of the lower risk of recurrence before delivery. There are still many unclear points regarding the management of condyloma in pregnancy, and further research is needed.
对于患有尖锐湿疣(一种发生于生殖道的人乳头瘤病毒相关良性肿瘤)的孕妇,目前尚无明确的管理指南。我们进行了一项系统综述,以更好地了解孕期尖锐湿疣的管理。在本综述中,我们主要关注治疗方法。我们检索了PubMed、谷歌学术和科学网,以确定关于孕期尖锐湿疣治疗的研究。30篇文章符合纳入标准。文献中描述的治疗方法有激光治疗、冷冻治疗、咪喹莫特、光动力疗法、三氯乙酸和局部热疗。最有效的治疗方法仍不明确。决定如何治疗时必须考虑各种因素。基于我们对文献的评估,我们推荐冷冻治疗作为首选治疗方法,激光治疗作为次选治疗方法。对于冷冻治疗或激光治疗不易治疗的广泛尖锐湿疣病例,可考虑使用咪喹莫特。在这种情况下,必须从患者处获得充分的知情同意。冷冻治疗、激光治疗和咪喹莫特在妊娠三期均有应用,且无严重不良反应,但由于分娩前复发风险较低,我们谨慎推荐将激光治疗保留至孕晚期。关于孕期尖锐湿疣的管理仍有许多不明确之处,需要进一步研究。