Low Grade Squamous Intraepithelial Lesion in Pregnancy

Low grade squamous intraepithelial lesion (LSIL) is one type of cervical dysplasia that can be seen on a Pap smear. Cervical dysplasia is a change on the cellular characteristics of the cervix as a result of one or more factors. Low-grade squamous intraepithelial lesion is considered a mild form of cervical dysplasia involving the presence of early changes in the morphology, size and shape of the cervical cells. The appearance of cervical dysplasia refers to the development of pre-cancerous tumors in the cervix. However, squamous intraepithelial lesion of the cervix may mean mild condition and will not eventually lead to cervical cancer if measurements are instituted. The presence of LSIL is detected following a Pap smear. The cervical cells normally have simple squamous epithelium. In LSIL, there is a mild change on the epithelium that may include presence of lesions or cell changes. LSIL is considered a cervical intraepithelial neoplasia 1 or CIN 1. It is the most common neoplasia and the most benign of all CIN. However, up to 16% of the cases of low grade squamous intraepithelial lesion can progress to other forms of CIN such as high grade squamous intraepithelial lesion (HSIL), which has a greater risk for developing into cervical cancer. The cause of LSIL is from the infection of Human Papilloma Virus or genital warts. Genital warts are often asymptomatic and the warts are barely seen. Women usually become infected without them knowing because some infections may resolve spontaneously. HPV infection should be prolonged to significantly cause cervical changes. Other patients may be diagnosed of LSIL few months or weeks before pregnancy. In this regard, LSIL may happen during the course of gestation. Low Grade Squamous Intraepithelial Lesion (LSIL) during pregnancy is slowly progressive, which means that it will not have significant development during the course of the pregnancy. This also means that its progression to cancer is not possible during pregnancy. With this regard, managements for LSIL are postponed until delivery because of fear of preterm labor or bleeding as a result of manipulating the cervix. Additional diagnostic tests such as colposcopy are also not warranted because of absence of invasive cancer and progression to cancer among pregnant women. However, it may be done in non-pregnant women to ascertain the diagnosis, but there is also a low rate of invasive cancer in this type of cervical dysplasia.