DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184134

Pap smear in antepartum women: an opportunity to screen and create awareness

Shanthi Ethirajan, Srinidhi R., Jayashree K.

Abstract


Background: Cervical and breast cancers are the leading malignancies in females in India. Cancer cervix is preventable and treatable if detected at premalignant stage. Pap smear is a recommended screening method for cancer cervix and its precursors. Pap smear screening in antenatal period presents an opportunity to screen for premalignant cervical lesions and genital infections. This study was undertaken to determine the prevalence of abnormal cervical smears and genital infections among antenatal women.

Methods: It is a prospective study in which, 200 antenatal mothers at booking visit, were included in the study. Details on their demographic characteristics, obstetric profile, and past history of Pap test were collected. Liquid based cytology was used for the test. The cytological results were reported based on the Bethesda classification system 2001.

Results: Among 200 antenatal women 57% were between 21-25 yrs of age and 18% were less than 20 years. 38% of women were less than 20 years of age at the time of beginning of sexual activity. 56% were primi gravida and others were multi gravida. 95.5 % of women were literate. 89% of women were unaware of Pap smear test. Among the 200 Pap smear reports, 23% were normal, 55.5% nonspecific inflammatory changes, 8.5% Candida infection and 13% bacterial vaginosis. None were reported with premalignant changes.

Conclusions: In a population where people do not undergo Pap test due to varied reasons, antenatal Pap test not only provides an excellent opportunity to screen and create awareness for further screening, also helps detect genital infections.


Keywords


Antenatal Pap smear, Cervical cancer, Cervical cancer screening, Genital infections, Precancerous lesion, Pregnancy

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References


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

Monteiro PB, Monteiro Filho MP, de Figueirêdo JT, de Lima Saintrain MV, Bruno ZV, Carvalho FH. Cytology-Based Screening during Antenatal Care as a Method for Preventing Cervical Cancer. Asian Pacific J Cancer Prevent. 2017;18(9):2513-8.

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

Gonçalves CV, Duarte G, Costa JSD, Marcolin AC, Bianchi MS, Dias D, Lima LCV. Diagnosis and treatment of cervical cancer during pregnancy. Sao Paulo Med J. 2009;127(6):359-65.

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.

Ingprasarn A, Onaium N. Prevalence of Abnormal Conventional Pap Smear in Pregnant Women, Chonburi Hospital. Thai J Obstet Gynaecol. 2014;22(3):137-42.

McIntyre-Seltman K., Lesnock JL. Cervical Cancer Screening in Pregnancy. Obstet Gynecol Clin N Am.2008;35(4):645-58.

Economos KA, Perez NV, Delke IS, Collado ML, Tancer ML. Abnormal cervical cytology in pregnancy: a 17- year experience. Obstet Gynecol 1993;81(6):915-8.

McDonald SD, Faught W, Gruslin A. Cervical cancer during pregnancy. J Obstet Gynaecol Canada. 2002;24(6):491-8.

Shaheen R, Paliwal S, Bakoliya A. Prevalence of abnormal Pap smear in pregnant women attending the antenatal clinic in Dr S N Medical college and attached hospitals, Jodhpur. Indian J App Res. 2017;7(3):69-71.

Manikkam B. Screening for cervical cancer during pregnancy. Int J Community Med Public Health. 2016;3(9):2493-8.

Michael CW. The Papanicolaou Smear and the Obstetric Patient: A Simple Test with Great Benefits. Diagnostic Cytopathol.1999;21(1):1-3.

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.

Velayudham D, Nethaji S.. Opportunistic cervical cancer screening in pregnancy. Int J Med Res Health Sci, 2016;5(1):278-81

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 Ser Res. 2007;7(1):10.

Himabindu P, Kanwal A, Vasudha. Pap Smear in Antenatal Women - Routine Screening In Low Resource Settings. IOSR J Dent Med Sci. 2015;14(4):04-5.

Khaengkhor P, Mairaing K, Suwannarurk K, Thaweekul Y, Poomtavorn Y, Pattaraarchachai J, Bhamarapravatana K. Prevalence of abnormal cervical cytology by liquid-based cytology in the antenatal care clinic, Thammasat University Hospital. J Medical Assoc Thailand. 201 9;94(2):152.