Abnormal smear and now pregnant...

[Mum2Joshua09]

Hi ladies,

About 3 months ago the result of my smear test came back with mild abnormalities, CIN1. I am currently just about to turn 7 weeks pregnant and my inital thoughts were of worry. I immediately went to see my GP when discovering I was pregnant at 5 weeks and he was completely laid back about it and told me I would be fine to continue with the pregnancy (I was worried I was going to have to make an awful decision as I already have a son to take care of) as this is not cancer, which I already knew, and that it would progress very slowly if at all. He has referred me to a consultant at the hospital for a second opinion and to make me feel more confident and I have an appointment at the end of July. I spoke to the hospital and in his notes he had said to get me in for an appointment within 4 weeks.

Now, the fact that he didn't feel the need to get me in immediately makes me think that he also feels there's nothing to worry about. Also, I have done a bit of research online (which is how I discovered this site) and everywhere I look, even on the cancer research website, it says not to worry and just ensure that I am checked 3 months after the birth.

My husband and I haven't told anyone that we're pregnant because of this but I can't wait until the end of the July; I'll be practically into my second trimester!! My mum knew we were going to try again and she's been pleading with me not to try until I've had my follow up, as any concerned mum would do, so I've been feeling awful knowing that I am already pregnant!

Anyway, I'm just trying to get a thread of a few responses from people who may have experienced this themselves or know someone who has been in a similar situation, to reaffirm my confidence that is growing and to show mum that I'll be ok. If anyone has negative stories I am willing to hear those too as I would be stupid to ignore these.

I am not naive to think that it'll all be fine, I am aware that it could progress and that I could require treatment after the birth but can someone confirm to me, if it is in the CIN stages, it can be easily treated?

Thanks for your time and I look forward to your responses.

Ok, I'm 36 weeks and have been going through this exact situation. Here goes...

Got an abnormal smear in June/July 09, went for a colposcopy in September which showed CIN1. Got pregnant in November. Went for another colposcopy at 20 weeks which showed CIN2, and another at 33 weeks which showed CIN3. At which point I was in a state!

I've spoken to consultants, doctors etc who have all said that during pregnancy the cervix looks different and colposcopys are unreliable during pregnancy. Also, pregnancy does accelerate cell abnormalty but that it MAY return to CIN one when I go for another colposcopy 3 months after the birth.

I've panicked, cried, had an awful time dealing with the thought of these abnormal cells getting worse and worse but basically there's nothing anyone can do until the cervix returns to normal and a proper examination can be carried out.

I have been told it may return to normal and that the cells do go a bit mad during pregnancy...please ask if you have any other q's and I'll do my honest best

I had abnormal smears since my first one at 16, I susequently had smears every 6 months. I had cells removed from my cervix in 2002, and continued afterwards to have regular smears.
I gave birth in 2007 and had a smear (as one was due in October 2006, but I was already pregnant)all was fine, I am now due my next smear in October and it will for the first time have been 3 years between them, and I am a bit concerned as I am used to regular smears.

In answer to your question mine were treated by a loop excision biopsy and subsequent smears were normal, so yes they can be treated. From seeing my Consultant for the first visit till op,was around 5 months.

I know my case is slightly different as I wasn't pregnant at the time of my abnormal smears, but if I can help in anyway about the treatment please ask. Mine were CIN3 when treated.

CIN2 sorry not 3.

DueJuly - Thank you for your response. That is the first time I've read about it progressing and from what you've said, although it has progressed, you've made it to the point of pregnancy where you could in fact have an early delivery if the doctors felt it serious enough to do so. From what I've read, I'm sure when you come to have the checks after the birth, all will have returned to normal.

nunnie - Thank you for your response also. It has helped alot because I'm not due to go back for a follow up smear until 6 months has passed which works out to the middle of September at which point I'll be 18 weeks so almost half way through. So if you were CIN2 and they felt it ok for you to go 5 months before treatment then theoretically, if they were to check me again at 20 weeks, as they did for "DueJuly", and I had progressed to CIN2 also, I could get to 40 weeks without it going to far. Obviously it's not standard, we all have different bodies and the pregnancy hormones could make things worse. I still think my abnormal results were because of the fact that I had it done the day after my period ended. Because it had been a while since my first smear, I had forgotten when you were meant to go and assumed it was as long as you weren't bleeding. I have since been told it can be affected by hormones so hopefully things have already returned to normal.

Like you say it is not standard in anyway, everyone is different. My first abnormal smear at 16 was a CIN1 which by my next smear 6 months later was normal, then I had another normal smear 6 months after that, then abnormal CIN1 again, I can't honestly tell you how long it took to progress from CIN1 to CIN2, as it is standard to have 2 abnormal smears in a row here before referral.

From my final abnormal smear and referral wait it was almost 11 months in total before I went for surgery.

The Consultant will go through everything with you, make sure you write any questions down as you are likely to forget to ask something.

Try and enjoy your pregnancy and congratulations.

I would get a second opinion and insist on a colposcopy, biopsy of tiny pieces cut out of the affected area of the cervix.

Pregnancy hormones that allow fast growth of the fetus and altered immune system that allows the growth of a foreign organism in your body all work for faster development and growth of cancerous tissue.

One other thing I would worry about t would be infecting the baby with HPV as he passes through the birth canal. Ask your doctor (or another who is a little less laid back) what can be done to avoid this,

CoteDAzur, she is seeing the Consultant end of the month, so he will advise her on treatment plan I would ahve thought. Don't think she needs a second opinion unless she is unhappy with her Consultant. Or were you referring to duejuly not OP, sorry?

Sorry I missed that referral to consultant in OP.

They'll do a colposcopy as this is just an examination but OP won't be offered a biopsy unless there is a very obvious dangerous cancer there.

The reason I've been told that I can't have a biopsy is because during pregnancy and due to the increased blood volume and flow around the uterus it could bleed heavily. I've also been told lots of times (as I was/am worried) that even though my personnal colposcopy went from CIN1 to CIN3 very quickly this is most probably due to the increased cell growth during pregnancy and may well return to normal.

Just trying to give OP my experience as I have followed this up with a couple of consultants. They are very very unlikely to do anything until 3 months after the birth.

I have an elective c-section booked for 39 weeks (for other reasons) and they wouldn't even move this back a couple of weeks so I could get treatment a bit earlier.

I know when I got pregnant after having my loop excision biopsy, I was deemed a high risk pregnancy due to possible weakness of cervix from the surgery. I would be very suprised myself if a biopsy would be carried out during pregnancy.
They will go through all the options with you at your appointment.

Hope everything goes okay for both of you, for the remainder of your pregnancies and after.

Loop excision takes out a cone-shaped chunk out of the cervix. Mine was about 1.5 cm long.

In comparison, pieces cut out during colposcopy for biopsy are tiny. They are little bits that resemble nail clippings. You can hardly see them in the solution. This biopsy will not cause a weak cervix,

Loop is different than a cone biopsy, a cone is slightly more invasive than a loop.

No you are wrong.

Loop excision brings out a cone-shaped chunk because the electrified device is L-shaped. This is then sent to biopsy to make sure that all affected tissue is taken out.

You are thinking about cold knife conization, which is indeed more invasive.

What is a cone biopsy then?

Cone biopsy = cervical conization = the umbrella term that includes both loop excision and cold knife.

www.macmillan.org.uk/Cancerinformation/Testsscreening/Cervicalscreening/TreatingCIN.aspx

www.macmillan.org.uk/Cancerinformation/Cancertypes/Cervix/Symptomsdiagnosis/Diagnosis.aspx

Duejuly... are you ok now? I've just had treatment and I want to conceive soon but I'm scared