{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:34Z","timestamp":1756339594546,"version":"3.44.0"},"reference-count":30,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,15]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>In this case, a pregnant Indigenous woman presented with high-grade cervical lesions (high-grade squamous intraepithelial lesion (HSIL), cervical intraepithelial neoplasia grade 3 (CIN2\u20133) and was lost to follow-up for over 5 years, posing a unique management challenge. Despite higher regression rates in pregnant women, personalised care was crucial due to potential pregnancy-related intervention risks.<\/jats:p>\n               <jats:p>This case underscores the complexities of managing high-grade cervical lesions in pregnancy and highlights the significant burden of cervical cancer within Aboriginal and Torres Strait Islander communities. It emphasises the urgent need for equitable screening access, patient-centred care and culturally sensitive education among vulnerable populations.<\/jats:p>\n               <jats:p>Of particular note is the case\u2019s uniqueness, with the patient\u2019s CIN3 diagnosis persisting for over 5 years and spanning three pregnancies without definitive management. Post partum, a subsequent LLETZ revealed extensive HSIL (CIN3) involving ectocervical and endocervical margins. Due to margin involvement, the patient now requires ongoing surveillance, with continued risk of being lost to follow-up due to the factors described.<\/jats:p>","DOI":"10.1136\/bcr-2024-261808","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T19:15:06Z","timestamp":1733858106000},"page":"e261808","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating the challenge of high-grade cervical lesions (CIN3) in pregnancy: a near miss"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3460-6878","authenticated-orcid":false,"given":"Tithi","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, South Metropolitan Health Service and East Metropolitan Health Service Library and Information Service, Murdoch, Western Australia, Australia"},{"name":"Procedural Obstetrics and Emergency, WA Country Health Service, Karratha, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Fitch","sequence":"additional","affiliation":[{"name":"Procedural Obstetrics and Emergency, WA Country Health Service, Karratha, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"2025082712092390000_17.12.e261808.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06815-7"},{"key":"2025082712092390000_17.12.e261808.2","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/j.1749-6632.2001.tb03809.x","article-title":"Cancer and pregnancy","volume":"943","author":"Creasman","year":"2001","journal-title":"Ann N Y Acad Sci"},{"key":"2025082712092390000_17.12.e261808.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-012-2475-3"},{"key":"2025082712092390000_17.12.e261808.4","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ajog.2010.04.016","article-title":"Cervical dysplasia in pregnancy: a multi-institutional evaluation","volume":"203","author":"Fader","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"2025082712092390000_17.12.e261808.5","unstructured":"Australian Institute of Health and Welfare . 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