system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
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?
assistant
Colposcopy and biopsy now