Evaluation of papsmear in pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20212178Keywords:
Cervical cancer, Pap smear, Pregnancy, ScreeningAbstract
Background: Cervical cancer is common worldwide and ranks fourth among all malignancies for women. Cervical cytology (PAP smear) as a cancer screening method is most commonly used worldwide. Cervical cancer can be detected at an early stage by PAP smear which is a cost effective and easy to perform test which is also very safe in pregnant women, hence this study is taken up as an opportunistic time for cervical cancer screening to this accessible group of women during their antenatal period and to find detection rate of infectious diseases, precancerous and cancerous pathology of the cervix.
Methods: 500 pregnant women of age 21 years and above and between 16-24 weeks of gestation attending the antenatal OPD were included in the study. Scrapings were obtained from the ectocervix and sent for cytological evaluation. Findings were tabulated and statistically analysed.
Results: 7.2% of the patients in our study had cervical infection which included candidiasis and trichomonial infections. 0.4% of the patients had abnormal PAP report, and 88.2% had inflammatory smear implying higher risk of STD’s and pregnancy related complications.
Conclusions: The cervical cytology is highly recommended for the routine screening in the antenatal care clinic specially for women who had no prior cervical cancer screening. Awareness on cervical cancer, preventive measures and screening methods need to be strengthened among pregnant women when they visit health care facilities and also in the community settings.
References
Globacan. Cervical cancer: estimated incidence mortality and prevalence worldwide in 2012. 2012: Available at: http://globocan.iarc.fr/old/FactSheets/cancers/ cervix-new.asp. Accessed on 1st January 2021.
Neerja B, Daisuke A, Nand SD, Rengaswamy S. Cancer of the cervix uteri [J]. Int J Gynaecol Obstet. 2018;143:22-36.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11. Lyon, France. 2013: Available at: http://globocan.iarc.fr. Accessed on 1st January 2021.
Mahboobeh S, Solomon D, Philip E. Castle, Cervical Cancer Prevention—Cervical Screening: Science in Evolution,Obstetrics and Gynecol Clinics of North America. 2007;34(4):739-60.
Bonnez W, Reichman RC. Papillomaviruses. In G. L. Mandell, J. E. Bennett, and R. Dolin (ed.), Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 5th ed. Churchill Livingston, Philadelphia. 2000:1630-40.
Senapati R, Nayak B, Kar S K, Bhagirathi D. HPV Genotypes distribution in Indian women with and without cervical carcinoma: Implication for HPV vaccination program in Odisha, Eastern India. BMC Infect Dis. 2017;17:30.
WHO 2019 guidelines. Available at: https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer. Accessed on 1st January 2021.
Ries L, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, Mariotto A, Feuer EJ, Edwards BK. SEER Cancer Statistics Review. 1975–2002. Bethesda, MD: National Cancer Institute; 2004.
Nanda K, McCrory DC, Myers ER, LA Bastian, V Hasselblad, JD Hickey, DB Matchar Accuracy of the Papanicolaou test in screening for and follow-up of cervical cytologic abnormalities: a systematic review. Ann Intern Med. 2000;132:810-9.
Priya SS, Shankar R. PAP smear in pregnancy: a hospital based study. Int J Reprod Contracept ObstetGynecol. 2018;7:4924-8.
RadhaBaiPrabhu T, Velayudham D, Nethaji S, Singhal H, venkatachalam R. Opportunistic Cervical Cancer Screening in Pregnancy. International Journal of Medical Research and Health Sci. 2016;5:2-278.
Manikkam B. Screening for cervical cancer during pregnancy. Int J Community Med Public Health 2016;3:2493-8.
Khaengkhor P, Mairaing K, Suwannarurk K, Thaweekul Y, Poomtavorn Y, Pattaraarchachai J, et al. Prevalence of abnormal cervical cytology by liquid based cytology in the antenatal care clinic, Thammasat University Hospital. J Med Assoc Thai. 2011;94:152-8.
Dinc A. Pap Smear Screening Results for Turkish Pregnant Women. Asian Pacific J Cancer Prevention. 2012;13(11):5835-8.
Mohindroo N, Sharma A, Minhas S, Pathania K. Prevalence and associated risk factors of abnormal pap smear in pregnant women.Int J Reprod Contracept Obstet Gynecol. 2019;8:4980-4.
