PAP smear in pregnancy: a hospital-based study

Background: Pregnant and non-pregnant women are at similar risk for CIN and cervical cancer. The incidence of abnormal cervical cytologic findings during pregnancy is 0.72 to 1.67%. Approximately 86% of all squamous intraepithelial lesions (SIL) indentified during pregnancy are classified as low-grade SIL, whereas 14% are high- grade SIL. The aim of this study is to assess the incidence of Pap smear abnormalities among antenatal woman presenting to present hospital.Methods: A prospective study was conducted in present medical college hospital in the department of Obstetrics and Gynecology for a period of one year from Jan 2017 to Dec 2017. A total of 200 antenatal women were included in the study. Ayre’s spatula was used to conduct smear tests in this study. All smears were immediately sprayed with a fixative and sent to the department of Pathology. The cytological results were reported based on the Bethesda classification system 2001.Results: The pap smear report revealed that 26% of the subjects had inflammatory changes and for 66% it showed negative for intraepithelial lesion and for only 1% of the subjects had signs related to carcinoma cervix in which one patient had Atypical Squamous Cell of Undetermined Significance (ASCUS) and another patient had Low-grade Squamous Intraepithelial Lesion (LSIL) and no satisfactory sample was able to be obtained in 6% of the subjects. In present study authors found a statistically significant association between the age at marriage and the pap smear report, lower the age at marriage (<20 years) higher the incidence of inflammatory changes in the cervix and both the patients who were reported with ASCUS and LSIL were in the age of 15 and 16 years respectively.Conclusions: Clinicians should make every effort to educate, counsel and screen pregnant women if they have not had a Pap test in the past