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Case 25 - A 28-Year-Old P0 Woman with Adenocarcinoma In Situ Has Intraoperative Bleeding during a Cold-Knife Conization

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
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Summary

A 28-year-old female para 0, non-smoker, presents to discuss management of adenocarcinoma in situ (AIS) on colposcopic biopsy. She has been in a mutually monogamous relationship for the past four years, has had two lifetime partners, and uses combined oral contraceptive pills (COCs; ethinyl estradiol 20 mcg/norethindrone 1 mg PO daily) for contraception. She has no past surgical history and no known drug allergies. She had a normal wellness examination three months ago and completed the HPV vaccination series at age 26. Her past medical history is significant for abnormal Pap smear. Her cervical cancer screening history is as follows:

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 70 - 73
Publisher: Cambridge University Press
Print publication year: 2021

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References

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Jiang, Y, Chen, C, Li, L. Comparison of cold-knife conization versus loop electrosurgical excision for adenocarcinoma in situ (ACIS): a systematic review and meta-analysis. PLoS One 2016; 12(1): 112.Google Scholar
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Liu, Y, Qiu, HF, Tang, Y, Chen, J, Lv, J. Pregnancy outcome after the treatment of loop electrosurgical excision procedure or cold knife conization for cervical intraepithelial neoplasia. Gynecol Obstet Invest 2014; 77: 240–4.CrossRefGoogle ScholarPubMed
Martin-Hirsch, PP, Bryant, A. Interventions for preventing blood loss during the treatment of cervical intraepithelial neoplasia (Review). Cochrane Database Syst Rev 2013; 2013(12): CD001421.Google Scholar

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