What is a contraindication for the next step in diagnostic evaluation following the finding of a 3 mm friable lesion on the cervix?

The identification of a 3 mm friable lesion on the cervix may prompt further diagnostic evaluation, commonly a cervical biopsy or excisional procedure to rule out malignancy or other significant pathology. However, pregnancy is a contraindication for certain cervical procedures due to the increased risk of complications such as bleeding, infection, and potential harm to the developing fetus.

During pregnancy, the cervix undergoes changes that can alter the risks associated with surgical interventions. Therefore, in pregnant patients, alternative monitoring strategies or non-invasive diagnostic methods (such as colposcopy without biopsy) may be considered to avoid risking the safety of both the mother and the fetus.

In contrast, prior cone biopsy, recent azithromycin use, and recent treatment of chlamydia do not inherently preclude conducting a biopsy of the cervical lesion, although they may be factors to consider in the overall management and timeline of care.