Colposcopy during pregnancy: Is it possible to do it in the early stages, what is prescribed procedure

As a diagnostic procedure colposcopy during pregnancy is carried out to identify possible cervical abnormalities. According to a survey taken a decision on the choice of mode of delivery - either naturally or by Caesarean section.

In the early stages of pregnancy, this non-invasive method helps to identify various cervical pathology - a precancerous condition, erosion, cancer. colposcope examination is carried out only on strict conditions, among which the central place is occupied by a suspicion of malignant degeneration of tissues.

During the extended colposcopy often found erosion. During pregnancy, it is not subject to treatment, or moxibustion therapy by conservative methods are appointed only after birth.

Colposcopy: it

Colposcopy for pregnant women - a non-invasive diagnostic method that allows to study the condition of the cervix. Manipulation is carried out with a special instrument, equipped with the optical apparatus. Also apply colorants.

Colposcope is introduced directly into the vagina. Pre-inserted into the mirror. The procedure does not cause any pain or discomfort. Test takes a maximum of 15-20 minutes at the gynecological chair, like during routine inspection.

If early pregnancy is carried out two types of tests:

• It represents normal inspection colposcope without the use of colorants;
• when expanded iodine solutions are used, acetic acid.

Simple diagnostics is estimated, to determine the size and shape, some diseases of the neck, the state of mucosal vascular pattern. If any suspicion of an atypical process is carried out extended colposcopy. It allows to examine the mucosal structure by treatment with acetic and salicylic acid. By using these substances epithelium swells, blood supply to the mucosa is reduced pathological changes are found.

Hromokolposkopiya - application of 0.1% hematoxylin solution or a 1% solution of nuclear dye. This is a more accurate method for determining the pre-cancerous and cancerous conditions of the mucosa.

For dynamic survey microcolposcopy applied. This histological examination of vaginal cervical area. It is carried out without painting or with the processing of individual cell elements using hematoxylin. It is indicated for the detection of pathologies during an extended method to study the changes in the dynamics.

Such a diagnosis is safe, it makes it possible to differentiate the gynecological diseases, to establish the exact location and the severity of atypical changes, structural disorders of the neck and make a final decision on holding delivery.

Indications during pregnancy

Colposcopy cervix during pregnancy is not only the basic method of prevention of cancer, it is shown in the following cases:

1. signs of erosion and other changes in cervical mucous, found during a routine pelvic exam.
2. Changes in the genitals - vaginal discharge, appearing in different periods of the cycle, pain, discomfort during intimacy, unpleasant odor. Acyclic spotting may be the first indication of a precancerous condition or neck indicate traumatic erosion.
3. Detection of abnormal cells on the smear cytology results. The most informative method for the detection of cancer cells is a biopsy, but colposcopy reveals localization of pathological changes and take the examination only the morphological changes of the mucous tissue.
4. Chronic inflammatory diseases. During pregnancy, they can worsen, causing acyclic malodorous discharge, pain in the vagina.
5. Check-ups after the treatment of cervical erosion, malignant neoplasms.

The survey is not mandatory, it can take on its own initiative. Woman sent to colposcopy on the results of a pre-existing stroke or in the presence of cervical dysplasia in history. From prevention to such an investigation is not carried out.

Contraindications to the procedure

Pregnancy and colposcopy are incompatible in the following cases:

1. Individual intolerance to substances used during the extended colposcopy.
2. Inflammation in the acute stage, localized in the cervical canal, or directly into the uterus.
3. The threat of interruption - bleeding in pregnancy, Hypertonicity. In this case, diagnostic testing possible after conserving therapy.
4. Recent surgery on the cervix.

In other cases, the procedure is safe for both the woman and the fetus. In the process of manipulation of the device does not injure the neck, allowing as accurately as possible to examine the state of the vagina, vulva.

Diagnosis using colposcopy

Colposcopy has extensive diagnostic capabilities. This procedure is used in gynecology to detect even minor changes, affecting the vaginal mucosa of the neck area. studied:

• epithelium color before applying the iodine solution and acetic acid, and after;
• surface structure - the presence of erosions, plaque elevation;
• diseased vessels;
• the location and size of altered epithelium tissue;
• determining lesions borders;
• the presence of open or closed glands, their condition.

According to the survey results can be diagnosed with the disease:

1. About Oncology says the presence of abnormal cells. In this case, colposcopy and biopsy precedes allows to establish the localization of foci modified for more precise tissue removal.
2. Differentiation cervicitis polyps of the cervical canal, Endometriosis, warts. Diagnostics also allows you to identify the development of erosion in the initial stage.
3. Identifying dysplasia rising by the presence of dense white plaques whose boundaries are determined by the application of iodine solution.
4. Acquired or congenital ectopia, erythroplakia.

Most cervical disease characterized by pronounced structure changes color, terrain mucosa, which is determined accurately during colposcopy.

Features procedures at different stages of pregnancy

Colposcopic signs of cervical lesions after conception become more pronounced now. A particular problem is considered detsiduoz pregnant. Such tissue reaction is a variant of the norm, but during gestation is stimulated by an increased level of progesterone. As a result, at ekzotserviksa and endometrial tumors may arise and polyps.

In the presence of pathology for adequate treatment is desirable to conduct research at the stage of conception planning. In the second and third trimesters of pregnancy colposcopy opportunities are limited, the procedure requires a doctor's professionalism and has more side effects.

In the early stages

Colposcopy during pregnancy is done according to strict indications. Usually its purpose is preceded smear. If it is found abnormal cells, conducted vagina and cervix diagnostics to pinpoint the lesion mucous membrane.

During the first three months of the procedure is completely safe and is carried out in the same way as non-pregnant women:

1. The neck is treated with a solution of vinegar. This allows you to remove a thick layer of sticky mucus that interferes with the colposcope. At this stage, the woman may feel a slight burning sensation.
2. Next, the processing of iodine solution (Lugol) to darken the reshaped portions mucosa.
3. Made tissue sampling for cytologic examination. Also taken swab for you to establish the presence of urogenital flora.

Probability bleeding arising after the procedure is less than 1%. To prevent side effects after the procedure is applied to the damaged portion of a cotton swab with an antiseptic.

In the 2nd and 3rd trimesters

Colposcopy study after the first trimester has several features:

1. In the second or third trimester around the external os appear swollen hypertrophied mucous buds cervical canal. Excretory ducts of glands dilate of them is viscous thick mucus. This picture can be taken as the initial disease stage, although these changes are considered to be physiological and disappear after 3-4 months after delivery.
2. By the end of pregnancy the physiological mucus becomes thick and viscous than hinder inspection. During colposcopic studies on these terms used processing cervix with 3% acetic acid solution, which allows to remove the thick coating.
3. It is also sometimes used additional mirrors and extenders walls. Position in the chair during the inspection of a woman should be different - it rests on the right thigh. In the usual vertical position lying pressure may drop sharply.

In identifying the disease at the time of the first inspection (usually when registering in the LCD) procedure appointed for a period of 8-9 weeks. Then, it was repeated in the 12-14 and 24-25 weeks (for further monitoring or evaluating treatment outcome).

The later stages

In the final period of pregnancy, a study conducted with great care, since the improper conduct, it may cause premature birth, bleeding and other unwanted effects.

At the end of the third trimester increases blood circulation of the mucous neck colposcope at careless use may injure it and cause bleeding. To prevent the paste is applied Moncel, which cover the treated areas of the mucous of the manipulation end.

Just before birth diagnosis is rare, mainly in cases of suspected malignancy of tissues, bleeding cervical erosion. According to its results selected mode of delivery - cesarean section or natural childbirth.

Pregnancy after colposcopy

The survey does not increase or reduce the possibility of conceiving a child, after the procedure there comes a healthy pregnancy in the absence of pathology of the reproductive system.

Even if colposcopy was performed during pregnancy in the very early stages (1-2 weeks) with no delay, it does not threaten the development of the child and women's health.

In the gestational period is generally used simple colposcopy for diagnosis, extended - for suspected malignant pathology.

Simultaneous biopsy (removal of a mucous cell research) is used in exceptional cases, as they often cause bleeding, miscarriage in the early stages.

Noninvasive colposcopy accurately investigate the structure and nature of cervical mucosa, to identify the initial stages of precancerous conditions.