During pregnancy, a doctor recommends several screening tests to keep off unnecessary and unexpected complications and to ensure a healthy pregnancy and trouble free delivery. Here we are going to discuss one of such test- Pap smear.The purpose of this test is to identify abnormal cell changes which can turn into cervical cancer in the future.A Pap smear test is very significant for women and it precisely saves her life.
What Is The Pap Smear Test Or Pap Test?
A Pap test is performed to search for abnormal changes in the cells of the uterine cervix. There are two main sets of cells, which cover the outer lining of the cervix. Squamous cells cover the exocervix and columnar or glandular cells cover the endocervix. These two types of cells meet at a place in the outer cervix called the squamo-columnar junction or transformation zone. It is in this region of the cervix the abnormal cells start to show up. During a Pap exam, your doctor will use ‘cervix sampler’ to remove sample cells from the surface of the squamo-columnar junction (SCJ) of the cervix which provides enough number of both types of cells. The sample cells are then spread on a slide (Pap smear) and sent to a laboratory for examination under a microscope. The cells are examined for irregularities that may point to abnormal cell changes, such as dysplasia (enlargement of tissues) or cervical cancer.
Every woman above the age of 21 years is recommended to do a Pap smear test once in every 3 years. After 30 years, it should be done once in 3 years or definitely once in every 5 years.
Why Is Pap Smear Included In Routine Prenatal Care?
A Pap smear test result can assist in finding out cell abnormalities which indicate infections, inflammations or even the possibilities of cervical cancer. Though, normally, cancer will not worsen as the pregnancy progresses or will affect the outcome of pregnancy, the infections can harm the unborn child. Therefore, early recognition of infection is vital.
Is Getting A Pap Smear Safe During Pregnancy?
Yes, it’s quite safe as Pap smear doesn’t do any harm to fetus or the mother. The brush, which is centrally placed in the cervix sampler will go into the cervical canal to a maximum depth of .7 cm. The cervical canal is 3 to 4.5 cm long. Therefore, there is considerable space between the place where the cell samples are taken and the uterine cavity where the baby is accommodated. Hence, the scrapping of the sample cells, leading to miscarriage is beyond the bound of possibility.
Though you may experience slight vaginal bleeding (not significant to cause any issues) after the Pap smear as:
The cervix is more vascular in the course of pregnancy
During pregnancy, the number of columnar cells will be more in SCJ. Unlike squamous cells, columnar cells bleed more easily when scrapped
The bleeding will be of a small quantity and will break off eventually.
When Is Pap Smear Scheduled In The Course Of Pregnancy?
Generally, the Pap smear is performed during the first antenatal visit or the doctor will convince the mother and will execute it during her second antenatal visit. Yet, it is mostly scheduled during the first trimester of gestation. Once you skip the Pap smear during the first trimester of pregnancy the doctor may sometimes put off the test until you give birth. But, they will insist on doing it in the second trimester if you have not performed the test for the past five years.
However, if you miss the Pap test in your second trimester also, most of the doctors prefer to do it after delivery because as the pregnancy hormones increase, the cells may show different behavior. This increase the chances of false positive results. Even if the false positive result is not harmful, it can cause unnecessary strain and worries during the pregnancy.
What Can Be Learnt From The Pap Smear Test Result?
Before analyzing the result you have to keep in mind that this is only a screening test rather than diagnosis. A negative or normal result shows that the cervix is normal and the sample collected has enough cells and no abnormal cells are found. A positive result suggests the presence of abnormal cells. Besides, an abnormal pap sometime indicates that the sample did not contain enough cells. Whatever the reason, an abnormal Pap result requires another Pap smear or further evaluation like colposcopy within another few months.
What If I Am Pregnant And My Pap Smear Examination Is Positive?
If your Pap smear test is positive, more tests will be needed to figure out whether you have infections, inflammations, a yeast disease, or the human papilloma virus. Analysts believe that the human papilloma virus (HPV) is a major risk factor for cervical cancer.
If your Pap result is abnormal, the doctor will decide the treatment depending on the severity of the abnormalities.
When the cell changes are minor, you will be closely monitored. In most cases, minor abnormalities of the cells are found to revert to normal after delivery
When the cell changes are moderate, further evaluation – colposcopy is required. This is examining the cervix with a microscope. This will help to recognize the severity of infections and inflammations of the tissues
When the cell changes are severe, further evaluation like a cervical biopsy is administrated to rule out the possibilities of cervical cancer
If the treatment can wait until delivery the doctor will not go for strong medication during pregnancy. But invasive (having a tendency to speared fast) cervical cancer needs to be treated at the earliest. As the treatment can cause significant issues, the treatment is usually handled by a team which includes professionals who specialize in cancer treatment and in carrying on high-risk pregnancies. Similarly, fast-spreading infections can harm the baby and need to be treated as fast as possible. This should also be administrated by experienced hands.
In short, the Pap test does not possess any risk if performed during pregnancy.On the other hand, an unknown and untreated infection in the cervix can cause several issues for your unborn baby. Therefore go ahead with a routine Pap smear during your first antenatal visit itself.