Postpartum Pap Smear Results in Women with Abnormal Pap Smears Detected at First Antenatal Care: A Retrospective Study in a Songklanagarind Hospital

Abstract

Objective: To assess the remission rate at postpartum periods of abnormal Pap smears during pregnancy, and to identify the demographic and clinical characteristics of pregnant women with abnormal Pap smears.Material and Methods: Pregnant women, who had antenatal care (ANC) in Songklanagarind Hospital in period of January 2011 to December 2019, were identified retrospectively. Exclusion criteria included inaccessible results of Pap smears during pregnancy and postpartum periods. Medical records of all pregnant women with abnormal Pap smears were reviewed. The association between Pap smear results during pregnancy and postpartum were analyzed by Cramer’s V statistic ranging from 0 to 1, with a 1 indicating perfect association.Results: Of these 8,238 pregnant women had available Pap smear results, 109 (1.3%) women were shown with abnormal results. The most common of abnormality from Pap smears were atypical squamous cells of undetermined significance. In postpartum period, 50 women who had abnormal Pap smear during pregnancy, underwent postpartum follow-up examination at six weeks postpartum, respectively. The majority of results (84.0%) were normal whilst rate of remission occurred in 45 women (90.0%). The association of Pap smears between during pregnancy and postpartum was shown to have a small association (Cramer’s V = 0.2).Conclusion: There was low prevalence of abnormal Pap smear during pregnancy and high remission rate at postpartum. However, health care providers should be aware of cervical cancer screening in all pregnant women, because many women had not undergone cervical cancer screening before pregnancy.