INCIDENCE: - The incidence of invasive Carcinoma of cervix is about 1 in 2500 pregnancies.
ASYMPTOMATIC CASES: - Cytologic screening of all pregnant mothers is a routine during antenatal checkup in the organized sector. Cases showing dyskaryotic smear are subjected to colposcopic directed biopsy.
SYMPTOMATIC CASES: - In cases of Bleeding during pregnancy either in early months stimulating threatened abortion or in later months constituting APH, the cervix should be inspected through a speculum at the earliest opportunity. If suspicion arises, a biopsy from the site of lesion confirms the diagnosis.
PITFALLS IN DIAGNOSIS DURING PREGNANCY: - Because of increased vascularity, softening of cervix and Gestational hyperplasia of the cervical mucosa, the following problems may arise in diagnosis.
1) Indurated feel of malignancy may not be evident.
2) Benign lesions such as ectopy or polyp may bleed to touch.
3) Extension to the parametrium may not be well defined and as such, cases are often understated.
EFFECTS OF PREGNANCY ON CARCINOMA CERVIX:-
The malignant process remains unaffected. There may be a rapid spread following vaginal delivery and induced abortion.
EFFECTS OF CARCINOMA ON PREGNANCY: -
There is increased incidence of: -
2) Premature labour.
3) Secondary Cervical dystocia.
4) Injury to the cervix and lower segment leading to traumatic PPH.
5) Lochiometra and pyometra.
6) Uterine sepsis.
ABNORMAL CYTOLOGY IN PREGNANCY: -
There is intense basal cell hyperactivity of the cervical epithelium during pregnancy. This however, reverts back to normal within 6 weeks postpartum. Abnormal Cytology, detected on routine screening procedure during antenatal checkup is placed under the following evaluation protocol.
HOMOEOPATHIC MEDICINES FOR CARCINOMA CERVIX WITH PREGNANCY
1) Iodium: - Ailments from hormonal imbalance. It is a cancerous growth of cervix because of hormonal imbalance because of Dyspepsia, dysplasia, hypertrophy of cervical canal that lead to chronic discharges.
Swelling and induration of ulcers mark weakness with menses and pain in thighs.
Inflammation of cervix with grade plug more than 1st degree neoplasia and changed cervical gland.
2) Kreosotum: - It is indicated for Carcinoma especially for squamous cell carcinoma of cervix. It is indicated at specially in menopausal age due to rapid decomposition of secretion. Female having excessive vaginal Bleeding after coition.
3) Hydrastis: - Ailments from defective assimilation and bad effects of syphilis and gonorrhea. It is indicated in Ulcerative type of cervical carcinoma. Cervical erosion with discharge of blood or thick, yellowish and stringy discharges. It is indicated from early till later stage of Carcinoma.
4) Natrum Mur: - Ailments from grief, fright, anger, profuse menses, and loss of vital force. Indicated in early stage of Cervical Carcinoma.
5) Thuja: - Ailments from suppression of Gonorrhea and other. Cervical carcinoma has tendency to spread specially over the vaginal surface of cervix to right and left fornices, so there are chance of invasion and inflammation of vagina.