Abstract
The author of the article clearly presents the management of precancerous pregnancies from the pathologist's point of view. It is important to emphasize that the only screening test for precancerous throat, both during and outside pregnancy, was, is and will be cytology.
It is also true for pregnancy collection, as well as outside them, that we must obtain cells from the junctional zone. Cytology should be taken at the first examination of pregnancy, because in the case of pathology, diagnosis is easier at the beginning of pregnancy, and treatment is also limited, if necessary, by the length of pregnancy.
Sampling plastic brushes recommended by Professor Ferenczy are expensive in our conditions and I do not know if there is currently a distributor. We ourselves use classical "brushes" for the collection of endocervical cytology and we do not have a larger percentage of unsatisfactory cytologies.
ASC-US cytology (atypical squamous cells of undifferentiated significance) is a very problematic unit for management. At present, after the revision of the classification in Bethesda, when the old ASCUS unit was divided into ASC-US and ASC-H subunits, our situation is simpler.
If we diagnose ASC-H, it is necessary to send a pregnant patient for expert colposcopic examination, because this cytology cannot rule out a high-grade lesion. If a woman has ASC-US cytology, we have the same options as the author describes.
In our conditions, however, it is most economical to send a patient for a colposcopic examination or repeat cytology, because HPV testing still remains relatively expensive, albeit the simplest examination.