Prevalence of abnormal Pap smear in pregnant women

Authors

  • Kakoli Nikhil Banerjee Department of Obstetrics and Gynecology, F. H. Medical College and Hospital, Agra, Uttar Pradesh, India
  • Poonam Rani Department of Obstetrics and Gynecology, F. H. Medical College and Hospital, Agra, Uttar Pradesh, India
  • Mukul Chandra Department of Obstetrics and Gynecology, F. H. Medical College and Hospital, Agra, Uttar Pradesh, India
  • Fayaz Khan H. Department of Obstetrics and Gynecology, F. H. Medical College and Hospital, Agra, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20252341

Keywords:

Abnormal cytology, Antenatal care, Bethesda system, Cervical cancer screening, Pap smear, Pregnancy

Abstract

Background: Cervical cancer is a leading cause of morbidity and mortality among women, particularly in low-resource settings. Pregnancy presents an opportunity for early cervical screening, yet routine screening programs remain inadequate. This study aims to determine the prevalence of abnormal Pap smears in pregnant women and assess the association of abnormal findings with age and clinicodemographic characteristics.

Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, F.H. Medical College and Hospital, Agra. A total of 197 pregnant women undergoing routine antenatal Pap smear screening were enrolled. Cytological evaluation was performed using the Bethesda classification system. Statistical analysis was conducted using SPSS version 26, with chi-square tests applied to determine associations between variables.

Results: Among 197 participants, 73.1% had normal or inflammatory smears, while 26.9% had varying degrees of epithelial abnormalities. The prevalence of ASCUS, Low SIL and High SIL were 10.7%, 8.6% and 7.6%, respectively. No cases of squamous cell carcinoma were identified. Women aged 30-40 years exhibited the highest proportion of abnormal Pap smears (49%). Rural residence, lower socioeconomic status and multiparity were associated with increased prevalence of abnormal cytology, though age was not statistically significant as a risk factor.

Conclusions: The study highlights a significant proportion of abnormal Pap smears among pregnant women, underscoring the importance of integrating cervical cancer screening into routine antenatal care. Awareness programs, early HPV vaccination and improved access to gynecological services are essential strategies for reducing the burden of cervical cancer in pregnant populations.

Metrics

Metrics Loading ...

References

National Centre for Disease Informatics Research. National Cancer Registry Programme, ICMR Three Year Report of Population Based Registries, 2009- 2011. Bangalore, India: NCDIR-NCRP (ICMR); 2014.

Castellsagne X, de Sanjose S, Aguado T, Louie KS, Bruni L, Muñoz J, et al. HPV and cervical cancer in the world. 2007 report. WHO/ICO information centre on HPV and cervical cancer. Vaccine. 2007;25(3):1-26.

He Y, Wu YM, Wang T, Song F, Wang Y, Zhu L. Perinatal outcomes of pregnant women with cervical intraepithelial neoplasia. Archives of gynecology and obstetrics. 2013;288:1237-42. DOI: https://doi.org/10.1007/s00404-013-2889-6

Hong JN, Berggren EK, Campbell SL, Smith JS, Rahangdale L. Abnormal cervical cancer screening in pregnancy and preterm delivery. Paediatric and perinatal epidemiology. 2014;28(4):297-301. DOI: https://doi.org/10.1111/ppe.12132

Malaysia – Global Cancer Observatory. World Health Organisation. 2020. International Agency for Research On Cancer. 2020.

Tao L, Xin TL, Han HL, Li LX. Prevalence and risk factors for cervical neoplasia: a cervical cancer screening program in Beijing. BMC Public Health. 2014;14:1185. DOI: https://doi.org/10.1186/1471-2458-14-1185

Su SY, Huang JY, Ho CC, Liaw YP. Evidence for cervical cancer mortality with screening program in Taiwan, 1981–2010: age-period-cohort model. BMC Public Health. 2013;13:1-7. DOI: https://doi.org/10.1186/1471-2458-13-13

Keane A, Ng CW, Simms KT, Nguyen D, Woo YL, Saville M, et al. The road to cervical cancer elimination in Malaysia: Evaluation of the impact and cost‐effectiveness of human papillomavirus screening with self‐collection and digital registry support. International journal of cancer. 2021;149(12):1997-2009. DOI: https://doi.org/10.1002/ijc.33759

Fan L, Zou LY, Wu YM, Zhang WY. Factors associated with abnormal cervical cytology in pregnant women. Zhonghua Fu Chan Ke Za Zhi. 2010;45(2):109-13.

Kimman M, Norman R, Jan S, Kingston D, Woodward M. The burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN). Asian Pacific J Canc Prevent. 2012;13(2):411-20. DOI: https://doi.org/10.7314/APJCP.2012.13.2.411

Niyaf N, Bhavya H, Ravikanth G, Geeta JD. Papanicolaou smear in pregnant women: A prospective study. New Indian J OBGYN. 2022;8(2):220-6. DOI: https://doi.org/10.21276/obgyn.2022.8.2.13

Ngaojaruwong N, Vuthiwong C, Punpuckdeekoon P, Thongsorn N. Prevalence of abnormal papanicolaou smear in pregnant women at Phramongkutklao Hospital. Thai J Obstet Gynaecol. 2008:179-86.

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 Thailand. 2011;9;94(2):152.

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;14(5):1296-9. DOI: https://doi.org/10.18203/2320-1770.ijrcog20150699

Sueblinvong T, Suwannarurk K, Chanthasenanont A, Treetampinich C, Pongrojpaw D. Prevalence and management of abnormal pap smear in antenatal care clinic at Thammasat University Hospital. J Med Assoc Thai. 2005;88(2):133-7.

Pokharel A, Shrestha A, Shrestha D, Aryal S, Tiwari A. Prevalence of Abnormal PAP Smear in Pregnancy: A Hospital-Based Study in Western Nepal. Journal of Lumbini Medical College. 2022;10(2):1-8. DOI: https://doi.org/10.22502/jlmc.v10i2.489

Shrestha S, Tuladhar NR, Basnyat S, Acharya GP, Shrestha P, Kumar P. Prevalence of vaginitis among pregnant women attending Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu, Nepal. Nepal Med Coll J. 2011;1;13(4):293-6.

Mohindroo N, Sharma A, Minhas S, Pathania K. Prevalence and associated risk factors of abnormal pap smear in pregnant women. Int J Reprod, Contracept, Obst and Gynecol. 2019;8(12):4980-5. DOI: https://doi.org/10.18203/2320-1770.ijrcog20195356

Himabindu P, Kanwal A, PG V. Pap Smear in antenatal women-Routine screening in low resource settings. J Dental Medical Sciences. 2015;14(4):4-5.

Manikkam B. Screening for cervical cancer during pregnancy. Int J Community Med Public Health. 2016;3(9):2493-8. DOI: https://doi.org/10.18203/2394-6040.ijcmph20163059

Singh S. Incidence of bacterial vaginosis in patients with idiopathic preterm labour. International J Reproduction, Contraception, Obstet Gynecol. 2015;4(3):641-7. DOI: https://doi.org/10.18203/2320-1770.ijrcog20150066

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

Downloads

Published

2025-07-29

How to Cite

Banerjee, K. N., Rani, P., Chandra, M., & Khan H., F. (2025). Prevalence of abnormal Pap smear in pregnant women. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(8), 2671–2677. https://doi.org/10.18203/2320-1770.ijrcog20252341

Issue

Section

Original Research Articles