In cases of high-grade squamous intraepithelial lesions detected on cervical cytology during pregnancy, what is the appropriate management?

In cases of high-grade squamous intraepithelial lesions (HSIL) detected on cervical cytology during pregnancy, the appropriate management is colposcopy. This approach is recommended because colposcopy allows for thorough evaluation of the cervix, aiding in the determination of the extent of the lesion and whether any further intervention is necessary.

When a high-grade lesion is identified, it's crucial to assess its characteristics in detail, as treatment options may vary based on gestational age and other factors. Colposcopy is considered safe during pregnancy, posing minimal risk to both the mother and fetus, and it helps to establish an accurate diagnosis.

Immediate surgery is generally avoided during pregnancy due to the risks involved, including potential complications such as preterm labor or miscarriage. Observation without intervention might lead to delayed treatment of a potentially significant cervical lesion, while cryotherapy is not advisable for pregnant patients because it may pose risks to the pregnancy and does not adequately address high-grade lesions that may require more definitive treatment. Therefore, performing a colposcopy provides a balanced approach to managing the risk while ensuring maternal and fetal safety.