Neoplasia intraepitelial cervical durante el embarazo, experiencia institucional / Cervical intraepithelial neoplasia during pregnancy, Institutional Experience

RESUMEN

Resumen OBJETIVO: describir el tipo de atención médica, tratamiento y seguimiento de pacientes con neoplasia intraepitelial cervical (NIC 3) y carcinoma in situ durante el embarazo, su evolución y condiciones del recién nacido. MATERIALES Y MÉTODOS: estudio retrospectivo de pacientes atendidas en el Instituto Nacional de Perinatología entre los meses de enero de 2009 y diciembre de 2014. Se incluyeron pacientes con diagnóstico de NIC 3 durante el embarazo, con expediente completo y atendidas en el servicio de Obstetricia desde su ingreso para control prenatal hasta la terminación del embarazo y tratamiento oncológico definitivo. RESULTADOS: se identificaron 6 casos de pacientes embarazadas con diagnóstico de NIC 3 posterior a la toma de citología cervical. A todas se les realizó colposcopia y biopsia cervical, sin complicaciones secundarias al procedimiento. El diagnóstico histopatológico fue carcinoma epidermoide in situ en 3 pacientes y en otras 3 neoplasia intraepitelial cervical. Todas las pacientes recibieron atención multidisciplinaria, sin complicaciones obstétricas ni neonatales. El seguimiento promedio fue de 2 años. CONCLUSIONES: el diagnóstico oportuno de las lesiones precursoras de cáncer cervicouterino es indispensable y no se relaciona con inconvenientes perinatales derivados del tipo de acceso.

ABSTRACT

Abstract OBJECTIVE: Describe the approach, management and monitoring of patients with cervical intraepithelial neoplasia (NIC) 3 and in situ carcinoma during pregnancy, its evolution and perinatal outcomes. MATERIALS AND METHODS: We made a retrospective study of cases from January 2009 to December 2014 in women of the National Institute of Perinatology . We included patients who were diagnosed with cervical intraepithelial neoplasia 3 during pregnancy, with complete file and that received medical consultation of the oncology and obstetrics service since their admission to the hospital for prenatal control until de resolution of pregnancy and oncological definitive treatment. RESULTS: During the study period, 6 cases of pregnant patients where diagnosed with CIN 3, after cervical cytology was taken, a cervical biopsy was performed without complications secondary to this procedure; the histopathological diagnosis was In situ epidermoid carcinoma in 3 patients and Cervical Intraepithelial Neoplasia in the other 3. All patients were treated with a Multidisciplinary approach. None of the patients presented obstetric or neonatal complications; At the end of the puerperium, follow-up was continued,the mean follow-up after the definitive treatment was 2 years. CONCLUSIONS: The timely diagnosis of precursor lesions of CACU is indispensable, in turn, is not related to adverse perinatal outcomes derived from the approach and timely screening.