The Colposcopic Examination

Colposcopy is used to evaluate women with genital tract abnormalities and abnormal cervical cytology. It is an office-based procedure during which the cervix is examined under illumination and magnification before and after application of dilute acetic acid. Colposcopy may include a biopsy of lesions with characteristics of malignancy and premalignancy, such as acetowhite changes, abnormal vascular patterns, and failure to uptake iodine stain. Endocervical sampling may accompany colposcopy, particularly in the evaluation of nonpregnant women with cytology results of atypical glandular cells and adenocarcinoma in situ. Satisfactory colposcopy requires visualization of the entire squamocolumnar junction and margins of any visible lesions. While most midwives do not perform colposcopy, they will provide the pre- and postprocedure education, counseling, and evaluation of patients undergoing the procedure. This paper reviews essential information and gives special consideration to colposcopic examination in adolescent women, pregnant women, and postmenopausal women.