Abnormal Pap Smear during Pregnancy

Archived Q&A and Reviews

Oct 2003

I'm 10 weeks pregnant, and just had a pap smear come back that indicates I may have HSIL. I am also positive for the high risk version of HPV, so I'm considered high-risk for cervical cancer. My OB wants to do a colposcopy and possibly a cervical biopsy. I've read at various sites on the Web that biopsies during pregnancy aren't a great idea (risk of bleeding seems to be the biggest problem), and I spoke to a ob/gyn oncologist in LA who says he NEVER biopsies pregnant women, and always sends them to an expert colposcopist. Does anyone know of an expert colposcopist in the bay area? I'm not sure what to do here, whether to go with my docs decision (which will probably end up in a biopsy) or try to find someone else up here to go to. anon

Speak with Karen Smith McCune director at UCSF Health Care, Dysplasia Clinic 415-885-7878. They deal specifically with HPV / Dysplasia . You can ask for Dr. McCune, she's very compasionate and knowledgable. You're in good hands there. Good Luck ! :) anon

I too had an abnormal pap during pregnancy. My OB wanted to do a colposcopy with possible biopsy if she saw something. I asked her and several obs if this was safe during pregnancy and they all said it was. I did end up having a biopsy. It was slightly uncomfortable for a few days, but otherwise, no problems. I had another pap 3 mo. postpartum and it was normal. The only thing that was curious to me about the whole thing was that during my first pregnancy, my ob (a different one) said he didn't do paps because they frequently were abnormal in pregnant women.

I would definitely get a second opinion from another doctor before going through with a biopsy. And since you're already at a higher risk for cancer, it isn't a bad idea to see an OB/GYN who specializes in high risk pregnancy, and has some experience in this area. But definitely, yes, get that second opinion! Karin

Hi. I had a positive colpo for LSIL & HPV prior to getting pregnant and am in a high risk category due to a history of breast cancer. When I became pregnant my OB advised not doing biopsies until after delivery. She felt confident that changes could be tracked through the high powered viewing with vinegar to highlight the abnormal cells. As you said, risk of bleeding is the main worry. There has been, occording to my OB, no statistical association b/w miscarriage and having a biopsy. But, I still choose not to have a biopsy, and only have the colpo viewing. Remember that you are the health care consumer. From what I have read cervical dysplasia is a slow growing thing, and there has been no association with pregnancy speeding up the growth process. Also, it may be just a local bacterial thing that clears up on it's own. Ask your OB about monitoring every trimester with the high powered viewing & without biopsy. If she is very uncomfortable with this idea then seek out advise of 2+ other OB's prior to making your decision. My OB, prior to moving to the East Bay, was Dr. Pearlman @ Portola Women's Clinic. She was awesome, explained everything, called and talked about my options for 45 minutes @ 8:00pm because she knew I was going on a long trip and was nervous about the results of the test. Remember stress lowers your immune system. Take care of yourself. anon