Beschreibung:
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<jats:title>INTRODUCTION:</jats:title>
<jats:p>For many women, prenatal care represents the most likely opportunity to access health care and thus, is an ideal time to screen for cervical dysplasia and counsel appropriately. Prior studies show that delivery can increase the rates of regression of cervical dysplasia, however, few studies have looked into whether the mode of delivery (vaginal vs. cesarean) impacts the course of cervical intraepithelial neoplasia (CIN).</jats:p>
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<jats:title>METHODS:</jats:title>
<jats:p>A retrospective chart review at an urban academic hospital was preformed from 2009-2014 searching by ICD-9 codes for pregnancy, delivery, and cervical dysplasia. We compared antepartum and postpartum cervical cytology and pathology of 149 patients following cesarean versus vaginal delivery.</jats:p>
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<jats:title>RESULTS:</jats:title>
<jats:p>Two statistical analyses were performed. In the first analysis, we used the colposcopy result when available and the pap result only when no colposcopy report existed. Normal and LSIL/CIN 1 was classified as low grade dysplasia while HSIL/CIN 2/CIN 3 was classified as high grade dysplasia. We compared outcomes of pre- and post-delivery pathology with respect to vaginal delivery vs. cesarean delivery. Our results showed no statistical significance with dysplasia changes (regression or progression) based on mode of delivery. Our secondary analysis used mathematical extrapolation of the data when a pap screening or colposcopy result was missing either antepartum or postpartum. Overall, progression of dysplasia was more common than regression, regardless of mode of delivery (p=0.095 for CD, p=0.022 for VD).</jats:p>
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<jats:title>CONCLUSION:</jats:title>
<jats:p>Vaginal versus cesarean route of delivery does not impart a statistically significant influence or advantage on overall cervical dysplasia regression rates.</jats:p>
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