Prevalence of abnormal PAP smears in antenatal women in a tertiary hospital in India

Abstract

Background: Pregnancy provides a good time for opportunistic screening of our women who rarely attend for cervical screening. The prevalence of abnormal PAP smear in pregnant women in developed countries was 5-6%, however, no literature was available from India. Aim: To determine the prevalence of abnormal PAP smears in antenatal women presenting to our antenatal clinic. Methods: Women attending the antenatal clinic with gestation of <28 weeks were recruited after an informed consent and had a PAP smear by Ayre spatula and cytobrush or a broom type of cytobrush. The comfort level during smear taking & any problems noted were recorded using a pain score. The smears were stained using the PAP stain, were categorized as adequate or inadequate & classified as per Bethesda classification. Results: We had 150 women participating, the mean age was 24.2 yrs, the mean period of gestation was 17 weeks; 43.9% were nulliparous. Smear adequacy rate was 71.5% overall. Pain during procedure was reported in 2.9% of women, 18.3% had minor discomfort; 78.6% were comfortable. Minor bleeding during smear taking was noted in 15%; this was more with the cytobrush & broom than the Ayre spatula alone. Abnormal smears were seen in three women; two had AGC & one had LSIL. Conclusions: Opportunistic cervical screening during pregnancy is safe and well tolerated. Abnormal Cervical smears were seen in 2% of our pregnant women.