Spectrum of cytologic changes in pregnancy. A review of 100 abnormal cervicovaginal smears, with emphasis on diagnostic pitfalls.

OBJECTIVE

To review pregnancy-related changes in cervicovaginal smears and to distinguish them from neoplasia and dysplasia.

STUDY DESIGN

One hundred consecutive abnormal cervicovaginal smears from pregnant women obtained during 1992-1993 were reviewed. Corresponding biopsies that were available were also reviewed for cytologic correlation.

RESULTS

Sixty-one percent of cases showed inflammation changes, 21% contained low grade squamous intraepithelial lesion, and 9% had high grade squamous intraepithelial lesion. Diagnostic problems were encountered with decidual cells, Arias-Stella reaction and trophoblastic cells.

CONCLUSION

Both the clinician and pathologist must be aware of diagnostic pitfalls and false positive diagnoses in pregnancy. Hence, it is extremely important that the clinician notify the pathologist about the pregnancy status of the patient.