A cervical biopsy is a procedure to remove tissue from the cervix to test for abnormal or precancerous conditions, or cervical cancer. The cervix is the lower, narrow part of the uterus. It forms a canal that opens into the vagina. Cervical biopsies can be done in several ways.

1. PRESENTED BY:-
RIFAT LATIF
B.SC (N) 4 TH YEAR
ERA’S COLLEGE OF NURSING
GUIDED BY:-
DR.ANJALATCHI MUTHUKUMARAN
VICE PRINCIPAL
ERA’S COLLEGE OF NURSING

2. LEARNING OBJECTIVE /CONTENT :
• Introduction
• Definition
• Purpose
• Indication
• Contraindications
• Types
• Articles
• Procedure
• Side Effects
• Complications
• Summary
• Bibliography

4. INTRODUCTION
A Cervical Biopsy is a procedure to remove tissue from the cervix to test for
abnormal are pre conceruous condition or cervical condition.
The Cervix is lower narrow part of the uterus.
It forms a canal that opens into the vagina.
A cervical biopsy may be done to find cancer or precancer cells on the cervix. Cells
that appear to be abnormal, but are not yet cancerous, are called precancerous.
These abnormal cells may be the first sign of cancer that may develop years later.

5. DEFINITION
A Cervical Biopsy is a minor surgical procedure in which a sample of tissue is taken
from the cervix.
Definition of Cervical Biopsy in Pregnancy-
If a Cervical Biopsy is needed during the pregnancy. It does not usually caused
problems with the pregnancy though the risk of bleeding is greater after the first
trimester.

6. IMPORTANCE OF CERVICAL BIOPSY
• Abnormal menstrual bleeding
• Bleeding after menopause
• Absence of uterine bleeding
• Bleeding
• Polyps (noncancerous growths)
• Genital warts, which may suggest infection with human papilloma virus (HPV), a risk factor for
developing cervical cancer
• Diethylstilbestrol (DES) exposure in women whose mothers took DES during pregnancy, as
DES exposure raises the risk for cancer of the reproductive system

7. PURPOSE
• A Cervical Biopsy is important for the detection of cancer .
• Precancerous cells
• Three kinds of Cervical Biopsy-
• Punch biopsy
• Cone biopsy
• Endocervical curretage

8. INDICATIONS
1. Human pappilomavirus
2. Abnormality detected during a pelvic examination.
3. Symptoms of Cervical cancer such as vaginal bleeding after sexual intercourse
4. Irregular or heavy menstrual bleeding.

9. CONTAINDICATION
1. Infection
2. Incompetent Cervix
3. Pelvic pain
4. Heavy bleeding
5. Injury to tissue
6. Rare infection
7. Cervical stenosis
8. Vaginal years

10. TYPES
1. Punch biopsy
2. Cone biopsy
3. Endocervical curretage

11. TYPES OF CERVICAL BIOPSIES INCLUDE:
• Punch biopsy. This procedure uses a circular blade, like a paper hole puncher,
to remove a tissue sample. One or more punch biopsies may be done on different
areas of the cervix.
• Cone biopsy. This procedure uses a laser or scalpel to remove a large cone-
shaped piece of tissue from the cervix.
• Endocervical curettage (ECC). This procedure uses a narrow instrument called
a curette to scrape the lining of the endocervical canal. This is an area that can’t
be seen from the outside of the cervix.

12. PAP TEST
• The Pap test is useful for finding cancerous cells, and other cervical and vaginal problems such
as precancerous cells and inflammation.
• Your healthcare provider may use a Pap test to diagnose the following conditions:
• Inflammation
• Infection
• Abnormal cells
• Precancerous cells
• Cancer
• Your healthcare provider may do a test for the human papilloma virus (HPV) at the same time
as a Pap test. Infection with HPV is the most important risk factor for cervical cancer in women
over age 30.

13. CONTINUED
• A cervical biopsy may also be used to diagnose and help treat these conditions:
• Noncancerous growth (polyps) on the cervix
• Genital warts. These may mean that you have an infection with HPV. HPV is a
risk factor for cervical cancer.
• Diethylstilbestrol (DES) exposure if your mother took DES during pregnancy. DES
raises the risk for cancer of the reproductive system.

14. COLPOSCOPY
• colposcopy to view the opening to the uterus, called the cervix, and the vagina. It
uses an instrument with a magnifying lens and a light, called a colposcope.
• Cervix. The lower, narrow part of the uterus located between the bladder and the
rectum, forming a canal that opens into the vagina, which leads to the outside of
the body.
• Vagina. This is the passageway through which fluid passes out of the body during
menstrual periods. The vagina connects the cervix and the vulva (the outer
genitalia).

15. ENDOMATERIAL BIOPSY
• endometrial biopsy to take a small tissue sample from the lining of the uterus
(endometrium) for study. The endometrial tissue is viewed under a microscope to
look for abnormal cells.

18. ARTICLES
A clean tray containing.
• Kidney tray.-to collect the wet waste
• Paper bag –to collect the dry waste
• 2 Bowles- to keep the solution, to keep cotton
• Vaginal speculum-to visualize the vagina /cervix
• Acetic acid solution-to screen the cancer cell
• Alley’s forceps-to pick the tissue

20. PROCEDURE
1. Wash the hands with soap and water
2. Get informed consent
3. Explain the procedure to the patient and family members.
4. Patient will be asked to sign a consent form that give permission to do the
procedure.
5. Undress the patient completely or from the waise down and put on hospital gown.
6. Patient will lie on examination table with leg and feat supporters for pelvic
examination.
7. Put on vaginal speculum in to the vagina of the patient.
8. This will spread the walls of vagina to reach the cervix.

21. CONTINUE
1. Clean and soak the cervix. With vinager solution (acetic acid) this solution helps
make abnormal tissues turn white.
2. Patient may feel mild burning sensation.
3. Allis Forceps is used hold the cervix for biopsy.
4. The amount of tissue remove from the cervix.
5. Tissue will be send to lab for testing.
6. After procedure patient provide sanitory pad for bleeding.
7. Recording and reporting.

22. SIDE EFFECTS
Pain
Fever
Heavy bleeding.
A foul smelling vaginal discharge.

23. COMPLICATIONS
Secondary hemorrhage
Cervical stenosis
Infertility
Cervical incompetent leading to recurrent miscarriage.

24. SUMMARY

25. CONCLUSION
• HPV plus pap co- testing is now strongly recommend for
cervical cancer screening in women ages 30 to 65.
• If both test are negative, the screening interval every 5
year.
• HPV testing has excellent negative predictive value and
a negative test offers women better and longer
protection.

26. BIBLIOGRAPHY
1. Howkins & Bourne show’s text book of gyanecology.
Edition 6
2. D.C Dutta’s text book of gyanecology- Hiralal konar.
Edition 8th.