СОВРЕМЕННЫЕ АСПЕКТЫ ДИФФЕРЕНЦИАЛЬНОГО ПОДХОДА К ВЕДЕНИЮ БЕРЕМЕННЫХ, ОТЯГОЩЕННЫХ ЦЕРВИКАЛЬНЫМИ ИНТРАЭПИТЕЛИАЛЬНЫМИ НЕОПЛАЗИЯМИ
Keywords:
беременность, цервикальная неоплазия, CIN, рак шейки матки.Abstract
Диагностика и тактика ведения беременных с предраковыми поражениями шейки матки представляют собой трудную проблему для клиницистов. По-прежнему отсутствует консенсус относительно необходимости биопсии или конизации у беременных женщин, особенно в случаях, подозрительных на CIN III и Ca in situ. Вопросы диагностики, лечения, родоразрешения и мониторинга у беременных с заболеваниями ШМ практически не освещены в учебниках и научно-практических изданиях. В данном обзоре представлены рекомендации международного научного обществ и результаты крупных клинических исследований по ведению беременных с аномальными цитологическими мазками во время беременности. Обобщены современные знания о диагностике и лечении CIN во время беременности. Использованы материалы поисковой системы PubMed, рекомендации руководств Европейского и Американского онкологических обществ.
Выводы. Факторы риска, распространенность и скорость прогрессирования цервикальной интраэпителиальной неоплазии на фоне беременности сопоставимы с теми, которые наблюдаются у небеременных. Беременность не следует считать фактором риска для прогрессирования СIN. После исключения инвазивного рака лечение CIN может быть отложено после родов.
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