DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20212973

Pap smear screening in antenatal women: an opportunistic way to save life

Sana Siddiqui, Suhailur Rehman, Imam Bano, Sayeedul H. Arif

Abstract


Background: Cancer cervix is the most common genital tract malignancy encountered in developing countries. In India, first visit to the gynaecologist for most women is during pregnancy and it may be the only visit. Hence, prenatal care offers an excellent opportunity to implement cervical screening in patients of young age, especially in women who do not seek routine health care. Therefore, this study was conducted to know the prevalence of abnormal Pap smear among the ante-natal women and to evaluate the result in relation to various risk factors.

Methods: Cross sectional observational study conducted on 425 ante-natal women attending the antenatal clinic using questioner addressing various socio-demographic variables. Measures of central tendency calculated and result was tabulated by using chi-square test.

Results: Maximum number of cases in our study was NILM i.e.314 (74%) followed by 68 cases of Candida (16%), 30 cases of Bacterial vaginosis (7.1%) and 10 cases of Trichomonas vaginalis (2.4%). Only 3 cases of abnormal Pap smear was reported i.e. 2 of ASCUS and 1 of LSIL. Thus, prevalence of abnormal Pap smear was 0.7%.

Conclusions: In country like India where organised screening programme are not available, as well as the awareness and uptake of available services by the target population is also poor; screening in pregnancy is worthwhile and may be a viable option to reduce the burden of cervical carcinoma.

 


Keywords


Pap smear, Screening, Antenatal

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References


Sreedevi A, Javed R, Dinesh A. Epidemiology of cervical cancer with special focus on India. Int J Women’s Health. 2015;7:405-14.

Golikeri P. A new vaccine for cervical cancer and some good hope. http://cancersupport.aarogya. com/index.php?option=com_content&task=view&id=333&Itemid=361. Accessed on 10th November, 2009.

Dinc A. Pap Smear Screening Results for Turkish Pregnant Women. Asian Pacific J Cancer Prev. 2012;13(11):5835-8.

Walboomers JM, JacobsM, Manos MM. Human papillomavirus is necessary cause of invasive cervical cancer worldwide. J Pathology. 1999;189(1):12-9.

Bidus MA, Elkas JC, Scott Rose G. Cervical and vaginal cancer. Berek and Novac’s gynecology.15th edition. Philadelphia: Wolters Kluwer Publishers. 2012.

Yang Ji, Ki Tal Kim. Gynecologic malignancy in pregnancy. Obstet Gynecol Sci. 2013;56(5):289-300.

Esha K, Ghosh U. K, Garg P, Geetika T, Molly M, Rani B. A study of cervical intraepithelial Neoplasia in pregnancy. J Obstet Gynaecol Ind. 2014;64(3):193-6.

Bandyopadhyay S, Chatterjee R. HPV viral load determination during pregnancy as a possible cervical cancer risk. J Exp Clin Cancer Res. 2006;25(1):29-38.

Prabhu T.R.B, Velayudham D, Nethaji S, Singhal H, Venkatachalam R. Opportunistic cervical cancer screening in pregnancy. Int J Med Res Health sci. 2016;5(1):278-81.

Van Ballegooijen M, van den Akker-van Marle E, Patnick J, Lynge E, Arbyn M, Anttila A et al. Overview of important cervical cancer screening process values in European Union (EU) countries, and tentative predictions of the corresponding effectiveness and cost effectiveness. Eur J Cancer. 2000;36(17):2177-88.

Himabindu P, Kanwal A, Vasudha. Pap smear in Antenatal women-Routine screening in low resource settings. IOSR-JDMS. 2015;14(4):4-5.

Kurian C, Cyriac S. Cervical cytological changes detected by papanicolaou smear in antenatal patients attending a tertiary care centre. Eur J Can. 2014;50(4):13-14.

Mishra V, Dorairajan G, Neelaiah S, Chinnakali P. Prevalence of abnormal Pap smear during pregnancy in a teaching hospital in South India. Int J Reprod Contracept Obstet Gynecol. 2015;4(5):1296-9.

Ingprasarn A, Onaium N. Prevalence of Abnormal Conventional Pap smears in Pregnant Women, Chonburi Hospital. Thai J Obstet Gynaecol. 2014;22:137-42.

Economos K, Perez VN, Delke I. Abnormal cervical cytology in pregnancy: a 17-year experience. Obstet Gynecol. 1993;81(6):915-8.

Nygård M, Daltveit AK, Thoresen SØ, Nygård JF. Effect of an antepartum Pap smear on the coverage of a cervical cancer screening programme: a population-based prospective study. BMC Health Serv Res. 2007;7(1):10.

Hong JN, Berggren EK, Campbell SL, Smith JS, Rahangdale L. Abnormal cervical cancer screening in pregnancy and preterm delivery. Paediatric Perinat Epidemiol. 2014;28(4):297-301.

Ngaojaruwong N, Vuthiwong C, Punpuckdeekoon P, Thongsorn N. Prevalence of abnormal papanicolaou smear in pregnant women at Phramongkutklao Hospital. Thai J Obstet Gynaecol. 2008;16(3):179-85.

Yamazaki T, Inaba F, Takeda N, Huruno M, Kamemori T, Kousaka N, et al. A study of abnormal cervical cytology in pregnant women. Arch Gynecol Obstet. 2006;273(6):355-9.

Misra JS, Srivastava S, Singh U. Risk-factors and strategies for control of carcinoma cervix in India: hospital based cytological screening experience of 35 years. Indian J Cancer. 2009;46(2):155-9.

Adadevoh SW, Forkouh BK. Cervical cancer screening. Int J Gynaecol Obstest. 1993;43(1):63-4.

Bustreo F, Chestnov O, Kieny MP. Comprehensive cervical cancer control. A guide to essential practice. WHO, library cataloguing-in-publication data, 2nd Ed. World Health Organization. 2014.

Mathew A, George PS. Trends in incidence and mortality rates of squamous cell carcinoma and adenocarcinoma of cervix–worldwide. Asian Pac J Cancer Prev. 2009;10(4):645-50.

Kumar S, Padubidri VG, Daftary SN. Howkins & Bourne Shaw’s text book of gynaecology 17th edition. Elsevier RELX India Pvt Ltd New Delhi. 2018;408-9.

Richardson AL, Lyon JB. The effect of condom use on squamous cell intraepithelial neoplasia. Am J Obstet Gyn. 1981;140(8):909-13.