Gynaecological oncology: CIN in pregnancy: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: CIN in pregnancy

Sample item

A 26-year-old at 14 weeks has a cytology report of high-grade squamous intraepithelial lesion, and colposcopy shows no features of invasion. What is the best plan?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Repeat colposcopy during pregnancy and defer treatment until after delivery

In pregnancy, colposcopy is safe and CIN progression to invasion is rare, so treatment of CIN 2 or 3 is deferred until 6 to 8 weeks postpartum. Biopsy is limited to lesions suspicious for invasion, and endocervical curettage is avoided. Excisional treatment is reserved for suspected micro-invasion because of bleeding risk and pregnancy loss.

Option by option

  • A. Immediate loop excision

    Loop excision during pregnancy risks bleeding and miscarriage.

  • B. Repeat colposcopy during pregnancy and defer treatment until after delivery (correct)

    Correct. Follow with colposcopy and treat after delivery if no invasion is suspected.

  • C. Terminate the pregnancy

    Termination is not indicated for CIN.

  • D. Immediate cone biopsy with cerclage

    Cone biopsy is reserved for suspected invasion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Repeat colposcopy during pregnancy and defer treatment until after delivery. In pregnancy, colposcopy is safe and CIN progression to invasion is rare, so treatment of CIN 2 or 3 is deferred until 6 to 8 weeks postpartum.

Why is "Immediate loop excision" not the answer?

Loop excision during pregnancy risks bleeding and miscarriage.

Why is "Terminate the pregnancy" not the answer?

Termination is not indicated for CIN.

Why is "Immediate cone biopsy with cerclage" not the answer?

Cone biopsy is reserved for suspected invasion.

What concept does this question test?

It tests Gynaecological oncology: CIN in pregnancy in OBG. Biopsy is limited to lesions suspicious for invasion, and endocervical curettage is avoided. Excisional treatment is reserved for suspected micro-invasion because of bleeding risk and pregnancy loss.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: CIN in pregnancy?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.