Pap smear screening in mid-trimester pregnant women: a prospective observational study in a tertiary care centre

Abstract

Background: Cervical cancer is preventable if detected early, yet it remains a leading cause of mortality among women in India. While routine cervical screening is often underutilized during gestation due to safety and precision concerns, there is growing clinical interest in evaluating its relevance during the mid-trimester of pregnancy (14–28 weeks) to optimize maternal health monitoring. The study aims to evaluate the baseline prevalence and associated risk factors of abnormal Pap smears in pregnant individuals, while monitoring the subsequent progression or regression of identified cellular dysplasia throughout the postnatal period.

Methods: This hospital-based, single-site, prospective cross-sectional observational study systematically sampled and enrolled antenatal patients attending the outpatient department of Obstetrics and Gynecology at Silchar Medical College and Hospital during their mid-trimester (14–28 weeks).

Results: Cytological results from 200 participants revealed 47.4% normal smears, 28.65% inflammatory smears, 14.58% candidiasis, 4.69% bacterial infections and 3.65% Trichomonas vaginalis. Smear findings varied significantly across gestational age groups (p=0.001%)), with normal cytologies peaking at 19–23 weeks (57.6%) and candidiasis staging higher at 14–18 weeks.

Conclusions: Mid-trimester Pap smears are a safe, practical tool for opportunistic prenatal screening. Younger age groups (21–25 years) correlate with normal findings, whereas older cohorts trend toward inflammatory updates.