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cervical biopsy Definition A cervical biopsy involves the removal of a small sample of tissue from the cervix. The cervix is the lowest part of the uterus and contains the opening from the uterus to the vagina. The tissue sample is called a biopsy. Who is a candidate for the procedure? A cervical biopsy is done to detect cancer of the cervix or precancerous changes. A cervical biopsy is usually done after a woman has abnormal results from a Pap smear that is done as part of a pelvic examination. A Pap smear is a test in which the provider uses a small spatula and a brush to gently scrape cells from the woman's cervix. These cells are sent to a lab for testing. The Pap smear may show early, abnormal, cancer-like changes in the cervix cells. A colposcopy is an examination of the surface of the cervix through a magnifying scope. A woman should have a colposcopy, as well as a cervical biopsy, if one of the following conditions applies: She has 2 consecutive abnormal Pap smears . She has a suspicious-looking lesion on the cervix or vagina, with or without an abnormal Pap smear . Her Pap smear suggests the presence of human papilloma virus or HPV. This virus can cause genital warts and is linked to the development of cervical cancer. She has extensive genital warts on her vulva, which are the lips at the opening of the vagina . She was exposed to DES, or diethylstilbestrol, in her mother's uterus. Diethylstilbestrol, a potent medication to prevent miscarriages, has been associated with abnormal changes in the cervix of women exposed as fetuses. She has had one abnormal Pap smear that suggested moderately abnormal tissue growth or more severely abnormal cells . If necessary, a healthcare provider may safely perform a cervical biopsy on pregnant women. Usually, providers wait to take a cervical biopsy until after the delivery. How is the procedure performed? A cervical biopsy is done with the woman lying on her back with her feet in stirrups. The healthcare provider places a speculum inside the woman's vagina. This instrument helps enlarge the opening of the vagina, which allows the provider to see the cervix and vaginal interior. The healthcare provider uses a colposcope to magnify and examine the cervix and vagina. To make cells more visible under the colposcope, the provider puts a mild solution of vinegar on the area. Sometimes the healthcare provider also uses a solution of weak iodine. Then, the healthcare provider takes small bits of tissue, or a biopsy, from suspicious areas. The technique is called cervical punch biopsy. The woman may feel a brief pinch or cramp. The healthcare provider records the location of the abnormal areas and sends the tissue sample or samples to be viewed under a microscope. What happens right after the procedure? Cramping usually passes within minutes of the cervical biopsy. If she sits up too quickly, a woman may feel lightheaded. Lying down for a few minutes after the procedure prevents this. Any further cramping may be treated with an over-the-counter pain medication, such as acetaminophen or ibuprofen. The biopsy samples are sent to the laboratory to be examined under the microscope by the pathologist. The healthcare provider discusses the pathologist's findings with the woman. Abnormalities can range from mild cervical dysplasia, or slightly abnormal changes in the cells examined, to cancer of the cervix. Treatments and follow-up depend upon the exact diagnosis. What happens later at home? For 1 to 2 days after a cervical biopsy, a woman may have a small amount of pinkish discharge from the vagina. For 2 to 3 days afterwards, she should avoid sexual intercourse, douches, and tampons. What are the potential complications after the procedure? A woman may experience minor bleeding after a cervical biopsy. Other potential complications include heavier vaginal bleeding, infection, or allergic reaction to the iodine used in the procedure. Any new or worsening symptoms should be reported to the healthcare provider.

Author: Eva Martin, MD Date Written: 08/08/99 Reviewer: Eileen McLaughlin, RN, BSN Date Reviewed: 07/13/01 Potential conflict of interest information for reviewers available on request