Vulvar Intraepithelial Neoplasia in Pregnancy
When vulvar intraepithelial neoplasia (VIN / HSIL) is identified during pregnancy, the clinical approach differs meaningfully from standard non-pregnant management. Pregnancy introduces important considerations around the timing and choice of intervention.
Clinical scenario
In pregnant patients with vulvar intraepithelial neoplasia, observation without active treatment is recognised as a valid management strategy — provided an invasive lesion has been ruled out beforehand. This approach reflects the altered risk-benefit balance that pregnancy introduces.
When treatment is indicated
For cases in which active intervention is required, a specific ablative laser-based approach is part of the evidence-based pathway.
Full treatment criteria, procedural details, and sequencing are available in the complete protocol.
References
Observation without treatment is rarely carried out in HSIL (usual-type VIN), except in very limited lesions or pregnant women.
Observation without treatment is carried out in all cases provided an invasive lesion is previously ruled out.
In cases requiring treatment, CO2 laser vaporization is recommended.
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