Abnormal Pap Smear During Pregnancy

Majority of women are afraid of 'Pap smear test'. Pap smear is a widely accepted screening test for cervical cancer and it helps detect non-cancerous (benign) conditions, pre-malignant (carcinoma in situ) or malignant (cancer growth) conditions in the cervix. The credit for significantly lowered percentage of cervical cancer in the last few years goes to the Pap smear test which was invented by a Greek doctor Georgios Papanikolaou. Any abnormal growth of cells in the cervix is referred to as dysplasia and the test helps detect dysplasia. Undergoing a Pap test every year is essential for women above 21 years of age, or every woman should opt for this test within 3 years of becoming sexually active. If required, the doctor may ask a pregnant woman to undergo a Pap test. Abnormal Pap smear during pregnancy has to be analyzed with great care.

Causes of Abnormal Results of Pap Smear

The main causes of abnormal test results are:

• Sexually transmitted diseases such as herpes or gonorrhea
• Human Papillomavirus infection
• Excessive smoking or excessive consumption of tobacco
• Sex with more than one partner
• Genetic factors or family history of cervical cancer
• Unprotected sex

Pap Smear Results During Pregnancy

It is absolutely safe to undergo a Pap smear during pregnancy as it involves no risk for the fetus. In fact, Pap smear is an invariable part of the routine prenatal care, at many places. Presence of the virus called HPV which is responsible for the infection of the cervix, can be detected with the help of this test. HPV can cause skin or cervical cancer, and therefore understanding the relationship between Pap smear and HPV is very very essential for women. HPV spreads mostly through sexually transmitted diseases. Positive test results indicate presence of HPV. Abnormally growing cells sometimes exhibit symptoms like vaginal or genital warts.

Abnormal Pap Smear Results during Pregnancy

Don't panic after hearing about abnormal Pap test results. Doctors come to the final conclusion after performing the test several times. A colposcopy (a microscopic exam) or biopsy may lead to pregnancy complications. Your doctor will decide whether to perform other tests or not. Statistics show that the percentage of pregnant women having cancer is as low as 0.001. It is common to get abnormal results of Pap test during pregnancy but getting diagnosed with cancer during pregnancy is not so common. Pregnancy does not increase or reduce the risk for cancer, but for doctors, managing the cancer during pregnancy is a challenging job. Not only the life of the mother but also the life of the baby is at stake.

Actually a positive test result does not convey that the woman has cancer. A positive test result conveys the message that the woman should undergo some more tests. An abnormality can occur due to infection, inflammation, a yeast infection, trichomoniasis and herpes; which can be easily treated. Moreover, it is noticed that during childbirth, abnormal cervical cells are washed away.

Dysplasia or precancerous lesions generally grow very slowly and therefore can be followed with a conservative approach during pregnancy. After the birth of the baby, the doctor may recommend colposcopy to check whether the lesion is still there. If it is still there, the doctor will see whether the condition has worsened. This will help determine the treatment. In majority of cases, dysplasias disappear after the birth of the baby. If necessary, colposcopies are done at regular intervals during pregnancy. Colposcopy side effects are negligible.

Cervical dysplasia does not spread rapidly to nearby or distant organs like other cancers when the lesion is surrounded by normal tissue. If the entire lesion is visible under a colposcope, one can be sure that the problem can be managed conservatively. Sometimes, the lesion is only partly visible, as it extends up the canal out of sight. In such cases, greater risk is involved. Treating invasive cancer conservatively is quite risky. In such cases, a cone biopsy is recommended. How deep the site is, determines the risk involved. Cone biopsy may prove to be harmful and may result in pre-term labor and delivery. Therefore, early detection of the problem is very important.

Women who have had regular Pap smears and who have undergone regular gynecological checkup before becoming pregnant, generally do not suffer from any of the above mentioned problems during pregnancy. And if the recent Pap tests have been normal, then normally, they won't ever come across abnormal results during pregnancy. Women who haven't had a Pap test in several years before becoming pregnant are more likely to come across an abnormal Pap smear during pregnancy. Remember, although the root cause of all cervical cancers is dysplasia; dysplasia is not cancer; because all dysplasias do not go on to become cancer.