As cervical lesions are becoming younger and the age of childbirth is increasing, along with the advent of the second child, the occurrence of cervical lesions during pregnancy has increased and colposcopy during pregnancy has become a reality we must face. Can colposcopy be performed during pregnancy? What are the issues that need to be taken into account during pregnancy? What are the principles of management of cervical lesions in pregnancy? These are the questions we need to address. 1. Physiological changes during pregnancy Due to the increase in estrogen level, the cervix changes accordingly. The volume of the cervix increases and becomes softer, the cervical canal becomes ectopic, exposing the transformation zone for easy observation. There is active proliferation of squamous epithelial basal cells with deep nuclear staining and nuclear division. 2. Colposcopic features during pregnancy Under the influence of estrogen, the cervical epithelium thickens and the cervical ectopic transformation zone is exposed in the cervicovaginal area for easy colposcopic observation, and colposcopy shows an abnormal white acetate reaction with exaggerated abnormal colposcopic changes, which can increase the white acetate extent with cervical ectopia during pregnancy, but the heterogeneous vessels are uncommon, if there is no mosaic and heterogeneous vessels, simply In the absence of mosaicism and heterogeneous vessels, the increase in the white acetate epithelium alone is not evidence of progression of the lesion and can be followed up with a biopsy to determine the extent of the lesion. The patient was 30 years old, inadvertently became pregnant during an infertility test and was found to have TCT: HSIL, high-risk HPV+, pathological biopsy: HSIL involving glands, p16 immunohistochemistry +++. Close follow-up throughout the pregnancy showed an increase in the extent of white acetate lesions, but lacked the characteristic features of invasive carcinoma, and the lesions seen by colposcopy were significantly reduced after delivery, and the pathology was CIN3 on biopsy again. The risk of biopsy is bleeding and infection, sharp biopsy forceps need to be used, never pull the biopsy by force to avoid massive bleeding. After the biopsy, the bleeding should be stopped by compression with a gauze ball for 24 -48 hours and sexual intercourse should be prohibited. Colposcopy and biopsy should have adequate informed consent from the patient. Delivery of cervical lesions in pregnancy is entirely possible according to obstetric principles. Cervical lesions are not an indication for cesarean delivery, and there is no need for cesarean delivery for cervical lesions, and some scholars even believe that vaginal delivery is beneficial for lesion shedding and regression, so cervical lesions combined with pregnancy can be tried vaginally. Treatment can be delayed after a definite diagnosis of cervical lesions, and close follow-up observation during pregnancy is sufficient, with colposcopic and cervical cytological follow-up once at 8-12 weeks, to be followed by postpartum re-colposcopic and pathological evaluation and management with the results of the evaluation. Cervical conization is not recommended during pregnancy. Case 1 was observed closely throughout pregnancy and re-biopsied postpartum to administer treatment with post-biopsy pathology findings. The follow-up observation of cervical lesions in pregnancy is a test of the wisdom and faith of the doctor and the pregnant woman. In the current doctor-patient relationship, the doctor’s courage and careful consideration of arrangements, and the pregnant woman’s absolute trust and understanding of the doctor are prerequisites for success. All my pregnant women who were successfully monitored and followed up were well communicated with, and we must remember that communication is essential. Because colposcopy during pregnancy involves the pregnant woman and the fetus, and because colposcopic image characteristics are different from those of non-pregnant women, and because the criteria for judgment are different from those of non-pregnant women, it is recommended that colposcopy during pregnancy be performed by an experienced colposcopist, and that multidisciplinary cooperation between obstetrics and gynecology be used for follow-up during pregnancy.