question: Q:A 27-year-old G3P2002 presents to the clinic for follow up after her initial prenatal visit. Her last period was 8 weeks ago. Her medical history is notable for obesity, hypertension, type 2 diabetes, and eczema. Her current two children are healthy. Her current pregnancy is with a new partner after she separated from her previous partner. Her vaccinations are up to date since the delivery of her second child. Her temperature is 98°F (37°C), blood pressure is 110/60 mmHg, pulse is 85/min, and respirations are 18/min. Her physical exam is unremarkable. Laboratory results are shown below:
  
  Hemoglobin: 14 g/dL
  Hematocrit: 41%
  Leukocyte count: 9,000/mm^3 with normal differential
  Platelet count: 210,000/mm^3
  
  Blood type: O
  Rh status: Negative
  
  Urine:
  Epithelial cells: Rare
  Glucose: Positive
  WBC: 5/hpf
  Bacterial: None
  
  Rapid plasma reagin: Negative
  Rubella titer: > 1:8
  HIV-1/HIV-2 antibody screen: Negative
  
  Gonorrhea and Chlamydia NAAT: negative
  Pap smear: High-grade squamous intraepithelial lesion (HGSIL)
  
  What is the best next step in management?? 
  {'A': 'Colposcopy and biopsy after delivery', 'B': 'Colposcopy and biopsy now', 'C': 'Cryosurgical excision', 'D': 'Loop electrosurgical excision procedure (LEEP)', 'E': 'Repeat Pap smear'},